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Medicare May Help Seniors Stop Smoking
Dec. 30, 2004 – The public comment period is now
open on a new proposal by Medicare to provide new coverage allowing
certain senior citizens covered by Medicare who smoke to receive
counseling services that will help them quit the habit.
An estimated 9.3 percent of those age 65 and older
smoke cigarettes. About 440,000 people die annually from smoking related
disease, with 300,000 of those deaths in those 65 and older.
The Centers for Disease Control and Prevention
(CDC) estimated in 2002 that 57 percent of smokers age 65 and over
reported a desire to quit. Currently, about 10 percent of elderly
smokers quit each year, with 1 percent relapsing.
"The evidence available fully supports the hope
that seniors at risk of the diseases caused by smoking can quit, given
the right assistance," CMS Administrator Mark McClellan, M.D., Ph.D.
said. "As we add the 'Welcome to Medicare' exam and other preventive
benefits and drug coverage, this is another step in using the medical
evidence to turn Medicare into a prevention-oriented program."
"We're building on our efforts to help America's
seniors help themselves to quit smoking and live longer," HHS Secretary
Tommy G. Thompson said. "This new benefit, focused on treating seniors'
smoking related diseases, will go a long way toward reducing their risk
of dying prematurely. The combination of lives lost, unnecessarily, and
the cost of treating smoking-related diseases makes our investment in
smoking cessation benefits all that more important. It's never too late
to benefit from quitting smoking."
The proposal to cover smoking cessation counseling
comes in response to a June 2004 request from the Partnership for
Prevention (PFP). The PFP requested CMS open a national coverage
decision to consider coverage of tobacco cessation counseling as
detailed in the HHS Public Health Service (PHS) 2000 Clinical Practice
Guideline, Treating Tobacco Use and Dependence.
The guideline has been endorsed by many health care and professional
organizations. Based on the evidence reflected in the guideline, CMS
proposes to extend smoking cessation coverage to beneficiaries who smoke
and have been diagnosed with a smoking related disease or are taking
certain drugs whose metabolism is affected by tobacco use. This
announcement builds on a series of HHS initiatives designed to help
Americans quit smoking, including the opening of a new national quitline
(1-800-QUITNOW) and designating all HHS campuses tobacco-free.
While many may think those who quit smoking at age
65 or older fail to reap the health benefits of abstinence from tobacco,
the U.S. Surgeon General has reported that the benefits of cessation do
extend to quitting at older ages. Smoking cessation in older adults
leads to significant risk reduction and other health benefits, even in
those who have smoked for years.
The coverage decision involves Medicare
beneficiaries who have an illness caused or complicated by smoking,
including heart disease, cerebrovascular disease, lung disease, weak
bones, blood clots, and cataracts -- the diseases that account for the
bulk of Medicare spending today. It also applies to beneficiaries who
take any of the many medications whose effectiveness is complicated by
smoking -- including insulins and medicines for high blood pressure,
seizures, blood clots and depression.
"The best way to prevent the serious health
problems caused by tobacco is never to start using it. Millions of our
beneficiaries have smoked for many years, and are now experiencing the
heart problems, lung problems, and many other often-fatal diseases that
smoking can cause. It's really hard to quit, but we are going to do
everything we can to help," said Dr. McClellan. "I especially want to
urge smokers on Medicare who are just starting to experience heart
problems or lung problems or high blood pressure to take advantage of
this new help -- and more is coming."
Medicare's upcoming prescription drug benefit will
cover smoking cessation treatments that are prescribed by a physician.
CMS Chief Medical Officer Sean Tunis, M.D., said,
"Federal policy has acknowledged tobacco as the number one cause of
preventable death for decades now, and CMS has taken the lead in
implementing coverage policy for our seniors to deal directly with this
critical health problem."
In 1993, smoking cost the Medicare program about
$14.2 billion, or approximately 10 percent of Medicare's total budget.
On average, nonsmokers survived 1.6-3.9 years longer than those who have
never smoked.
The proposed new coverage policy is available for
review at the CMS coverage Web site (www.cms.hhs.gov/coverage).
The posting of this proposed coverage policy marks the beginning of a
30-day public comment period. After close of the comment period, CMS
will have 60 days to review the comments and issue a final policy.
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