Helping Parents Quit Smoking

By Donald Berwick, M.D., Administrator of the Centers for Medicare & Medicaid Services. Cross post from Healthcare.gov

As a pediatrician, I’ve seen too many children whose health problems could have been avoided if they hadn’t been exposed to cigarette smoke. And when parents smoke, it’s especially dangerous to their children.

Exposed to smoke, children are at greater risk of serious lower respiratory infections such as bronchitis and pneumonia. They are more prone to ear infections. If they have asthma, they have more frequent and severe attacks.

In pregnant women, smoking can cause serious complications. Babies born to mothers who smoke are more likely to be lower birth weight, have lung problems, and other health problems. They’re more likely to die from sudden infant death syndrome.

But it’s not easy for a person with a tobacco addiction to quit. That’s why it’s so important to reach pregnant smokers, with services like face-to-face counseling, telephone quit-lines staffed by specially-trained coaches, and—in very limited cases—medication, if a woman and her doctor determine that it’s necessary.

It’s why the Centers for Medicare & Medicaid Services (CMS) sent a letter to all state Medicaid directors today, reminding them that state Medicaid programs now must fully cover tobacco cessation services for pregnant women, as a result of the Affordable Care Act. In addition, CMS is making it easier for states to fund tobacco use treatment for all Medicaid beneficiaries by making funding available for quit-lines.

And smoking adults model unhealthy behavior for children. Every day, an estimated 4,000 children try their first cigarette; 1,000 of those kids become daily smokers. Helping the adults in their lives to quit is a powerful message to them not to start.

The State Medicaid Director letter was issued in conjunction with National Prevention and Wellness Month, to bring attention to the power of prevention to improve health and quality of life for millions of Americans. It’s just one way we’re making access to preventive services easier.

The Affordable Care Act also eliminated the Medicare Part B deductible and copayments for a host of preventive tests and screenings for seniors. We’re working on closing the Medicare Part D donut hole, since we know that making prescription drugs more affordable increases the chance they’ll be taken as needed to stay well.
If we’re successful at preventing disease and promoting health we might also bring down the high cost of health care. According to the Congressional Budget Office, the reduction in preventable health problems resulting from an investment in tobacco cessation services would create savings for states and the federal government. According to the American Legacy Foundation, we could save $9.7 billion over five years if every Medicaid beneficiary stopped smoking.

If you add in the intangible costs of pain and suffering, the costs of chronic illness are simply unacceptable. Everyone in the community—including parents and children—benefits when essential services that people need to stay healthy are within their reach.

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