State should support smokers who want to quit
Wednesday, April 8, 2009
The smokefree indoor air bill moving through the General Assembly is first and foremost about protecting the health of workers. It would give employees in restaurants, bars and other smoke-filled workplaces the same protection workers in smokefree environments enjoy. It's about time.
Additionally, by further decreasing the acceptability of smoking and limiting the number of places where people can smoke, the smokefree workplace bill would encourage many North Carolinians to quit.
But given the tremendous difficulty of giving up smoking, it is important we ensure smokers have the tools they need to quit. It is unrealistic to expect people to quit without help. Nicotine is, after all, as hard an addiction to break as heroin or cocaine, according to former Surgeon General C. Everett Koop.
Unfortunately, many health plans in North Carolina do not cover a full range of affordable smoking cessation tools, including comprehensive counseling programs as well as quitting aids like nicotine gum, patches, lozenges and prescription medications. According to the American Lung Association, the use of counseling and medications, individually, increase the likelihood of quitting, but used in combination they constitute the most effective approach.
It is true that state and local governments, individual companies and a number of health plans have made some efforts to provide cessation tools to smokers. The Health and Wellness Trust Fund's NC Quitline is a good example of state government providing smoking cessation services to the public.
But a program here or there is not enough. We need comprehensive, affordable programs for all North Carolinas who want to quit smoking.
The American Lung Association gave North Carolina an "F" for cessation coverage in the group's 2008 report card. (North Carolina also received F's for low tobacco prevention spending, lack of smokefree air, and for having one of the lowest cigarette taxes in the country.)
According to the report, neither North Carolina's Medicaid program nor its State Health Plan covers comprehensive cessation programs that include free or low-cost access to counseling and a full array of quitting medications. Furthermore, the state doesn't mandate that private health plans cover smoking cessation.
Given the cost burden smokers place on our health care system, it is hard to understand why state government and health insurers continue to limit affordable access to quitting tools. The average smoker costs an employer approximately $3,400 a year in lost productivity and medical expenditures, according to the Centers for Disease Control and Prevention. Smokers miss more work days due to sickness, have to take frequent breaks to smoke and experience higher rates of health complications that require expensive treatment.
Each year, smoking costs North Carolina $2.4 billion in direct healthcare expenditures ($769 million for Medicaid alone) and $3.3 billion in lost productivity, according to the Campaign for Tobacco Free Kids.
The economic incentive is clear. The state could boost productivity and save hundreds of millions in healthcare costs if we just reduce smoking rates. To achieve this, it will take a commitment on the part of businesses, state government and insurance companies to make smoking cessation a top priority.
The proposed smokefree workplace bill could act as a catalyst in reducing smoking rates in North Carolina and help save tens of thousands of lives and hundreds of millions of dollars. North Carolinians are ready for safe indoor air and are ready to kick the tobacco habit -- let's help them by fully funding tobacco-cessation programs.
