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Targeted Mass. Stop-Smoking Campaign Gets Dramatic Results Among Poor

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Smoking rates have declined 26 percent among low-income Massachusetts residents who were offered free smoking-cessation treatment by the state, the Boston Globe reported Nov. 18.

The program, sponsored by the Massachusetts Department of Public Health, targeted enrollees in MassHealth, the state's health insurance program for the poor. Patients were offered counseling and medication to help them quit.

A study found that not only did smoking rates decline but participants also had fewer emergency room visits for asthma attacks and that heart-attack rates also declined.

“These findings are extraordinary — they have major public-health implications as Congress is debating health-care reform,'' said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “These findings demonstrate that if Congress fully covers tobacco cessation, it has the potential to save literally tens of thousands of lives in the very near future and many more over the long term.”

Smoking rates tend to be higher among the poor, and smoking among low-income individuals has historically been difficult to snuff out. “They are truly the individuals who are harmed the most by tobacco in America today,'' said Michael Fiore, director of the University of Wisconsin-Center for Tobacco Research and Intervention. “The proportion of family income that Medicaid recipients have to devote to purchasing this drug they're addicted to, tobacco, is higher than for virtually any other group in our society.”

Under the Massachusetts programs, patients paid just $3 in copays for drugs and counseling. The initiative cost state taxpayers just over $10 million in the course of about two years.

The program was heavily promoted via media and in food banks and health clinics. About 75,000 MassHealth patients took advantage.

“We wondered if this population would be interested in cessation,” said Nancy Rigotti, director of the Tobacco Research and Treatment Center at Massachusetts General Hospital. “It turns out they were interested — they just couldn't afford it.”

Smoking rates among MassHealth patients declined to 29.6 percent by mid-2008, but held steady at over 36 percent among uninsured residents in the state. 

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