MMWR Morb Mortal Wkly Rep. 2004 Jan 30;53(3):54-7.
In 2000, of approximately 32 million persons who received health insurance coverage through Medicaid programs, an estimated 11.5 million (36%) smoked. One of the national health objectives for 2010 is to provide coverage by Medicaid in the 50 states and the District of Columbia (DC) for nicotine-dependence treatment. The Guide to Community Preventive Services recommends reducing the cost of tobacco-dependence treatments to increase the number of smokers who successfully quit smoking. The 2000 Public Health Service (PHS) Clinical Practice Guideline also supports expanded insurance coverage for tobacco-dependence treatments. The amount and type of coverage for tobacco-dependence treatment offered by Medicaid has been reported previously for 1998, 2000, and 2001. In 2002, all states and DC were surveyed again about the amount and type of coverage they provided. This report summarizes the results of the survey, which indicate that as of December 31, 2002, 1) 36 Medicaid programs covered some tobacco-dependence counseling or medication for all Medicaid recipients, 2) four states offered coverage only for pregnant women, 3) two states offered coverage for all pharmacotherapy and counseling treatments recommended by the 2000 PHS guideline, and 4) seven states covered all recommended medications and at least one form of counseling. To improve the health of populations with disproportionately high rates of smoking, the 50 states and DC should provide coverage under Medicaid for all recommended tobacco-dependence treatments.
2000年，在通过医疗补助计划获得医疗保险的约3200万人中，估计有1150万人（36%）吸烟。2010年的一项国家卫生目标是在50个州和哥伦比亚特区通过医疗补助计划提供尼古丁依赖治疗服务。《社区预防服务指南》建议降低烟草依赖治疗的费用，以增加成功戒烟的吸烟者人数。2000年公共卫生服务（PHS）临床实践指南也支持扩大烟草依赖治疗的保险覆盖范围。此前已报告了1998年、2000年和2001年医疗补助计划提供的烟草依赖治疗的覆盖范围和类型。2002年，再次对所有州和哥伦比亚特区提供的覆盖范围和类型进行了调查。本报告总结了调查结果，结果表明，截至2002年12月31日，1）36个医疗补助计划为所有医疗补助接受者提供了一些烟草依赖咨询或药物治疗，2）四个州仅为孕妇提供覆盖，3）两个州为2000年PHS指南推荐的所有药物治疗和咨询治疗提供覆盖，4）七个州涵盖了所有推荐药物和至少一种咨询形式。为改善吸烟率过高人群的健康状况，50个州和哥伦比亚特区应通过医疗补助计划为所有推荐的烟草依赖治疗提供覆盖。
