By North Carolinians for a Tobacco Free Generation
There’s good news and bad news when it comes to smoking and tobacco use in NC.
First the bad news: Over 19,000 North Carolinians die from cancer each year and 30.5% of these cancer deaths are attributed to tobacco use. Thankfully, many people want to quit using tobacco products, including 68% of adults who smoke cigarettes. Having access to evidence-based tobacco treatment, including cessation medications and behavioral treatment increase a person’s likelihood of quitting. However, without health insurance, uninsured people may face more barriers to treatment and lack the support that could help them quit.
The good news, is that Medicaid Expansion in our state could initially reduce smoking prevalence, ultimately reducing preventable death and disease in North Carolina. For example, when Medicaid coverage that included a tobacco cessation benefit was introduced in Massachusetts, it reduced the prevalence of smoking and there were increases in successful quit attempts in the state. Another study found that people on Medicaid who smoke were more likely to have made a past-year quit attempt than uninsured individuals. That is why North Carolinians for a Tobacco Free Generation support Care4Carolina’s goal to expand Medicaid in North Carolina with expanded coverage of tobacco-cessation services. We believe there should be fewer barriers to cessation support and that everyone should have access to evidence-based tobacco treatment in NC.
Having access to cessation services is particularly important for cancer survivors. If a cancer survivor continues to smoke, their risk of having cancer reoccur increases, treatment effectiveness is reduced, and their quality of life decreases. Research has shown that expanding Medicaid helps support cancer survivors; a recently published study among cancer survivors seen in community health centers shows that the probability of quitting smoking is lower in non-expansion states than among cancer survivors in expansion states. In this study among cancer survivors seen in community health centers, patients in expansion states were more likely to have a smoking cessation medication order and to have more than 6 office visits to their doctor when compared to cancer survivors in non-expansion states.
In addition to cancer, smoking is a significant risk factor for heart disease, stroke, chronic obstructive pulmonary diseases, diabetes, and asthma. Currently, tobacco use is the number one preventable cause of early death and disease in NC and the US. Expanding Medicaid with tobacco cessation benefits in NC can help increase the integration of cessation care into primary care and behavioral health care. It can also increase referrals to support systems including NC’s Quitline, and the use of effective tobacco treatment medications. These efforts will address and prevent tobacco use in our state and reduce the harms associated with prolonged use and exposure (i.e. secondhand smoke.)
If we want more good news when it comes to helping North Carolinians lead tobacco-free lives, we need to ensure that everyone has access to affordable, high quality health care and can access cessation services no matter which NC community they live in.
Closing the Medicaid coverage gap is a triple win:
1) It will help smokers quit and prevent many cancers from occurring in the first place;
2) Coverage will help to identify cancers earlier when they are treatable and improve cancer outcomes by 60%;
3) Coverage will help cancer survivors who are still smokers to get the care they need to quit smoking.
About us: North Carolinians for a Tobacco-Free Generation (NCTFG) is a partnership between the NC Tobacco Prevention and Control Branch, UNC Tobacco Prevention and Evaluation Program and the North Carolina Alliance for Health. NCTFG aims to educate the public and decision-makers on the harms of tobacco and secondhand smoke as well as effective policies and programs to reduce tobacco’s harm.