MMWR Morb Mortal Wkly Rep. 2024 Apr 11;73(14):301-306. doi: 10.15585/mmwr.mm7314a2.
The prevalence of cigarette smoking among U.S. adults enrolled in Medicaid is higher than among adults with private insurance; more than one in five adults enrolled in Medicaid smokes cigarettes. Smoking cessation reduces the risk for smoking-related disease and death. Effective treatments for smoking cessation are available, and comprehensive, barrier-free insurance coverage of these treatments can increase cessation. However, Medicaid treatment coverage and treatment access barriers vary by state. The American Lung Association collected and analyzed state-level information regarding coverage for nine tobacco cessation treatments and seven access barriers for standard Medicaid enrollees. As of December 31, 2022, a total of 20 state Medicaid programs provided comprehensive coverage (all nine treatments), an increase from 15 as of December 31, 2018. Only three states had zero access barriers, an increase from two; all three also had comprehensive coverage. Although states continue to improve smoking cessation treatment coverage and decrease access barriers for standard Medicaid enrollees, coverage gaps and access barriers remain in many states. State Medicaid programs can improve the health of enrollees who smoke and potentially reduce health care expenditures by providing barrier-free coverage of all evidence-based cessation treatments and by promoting this coverage to enrollees and providers.
美国参加医疗补助计划（Medicaid）的成年人中，吸烟的比例高于参加私人保险的成年人；超过五分之一的参加医疗补助计划的成年人吸烟。戒烟可以降低与吸烟有关的疾病和死亡的风险。有效的戒烟治疗方法是可用的，全面、无障碍的保险覆盖这些治疗方法可以增加戒烟率。然而，各州的医疗补助治疗覆盖范围和治疗获取障碍存在差异。美国肺脏协会收集和分析了关于标准医疗补助参保者的九种烟草戒烟治疗方法和七种获取障碍的州级信息。截至 2022 年 12 月 31 日，共有 20 个州的医疗补助计划提供全面覆盖（所有九种治疗方法），比 2018 年 12 月 31 日的 15 个有所增加。只有三个州没有任何获取障碍，比 2018 年的两个有所增加；这三个州也都有全面覆盖。尽管各州继续改善标准医疗补助参保者的戒烟治疗覆盖范围并减少获取障碍，但许多州仍存在覆盖差距和获取障碍。医疗补助计划可以通过为所有基于证据的戒烟治疗方法提供无障碍覆盖，并向参保者和提供者宣传这种覆盖范围，来改善吸烟者的健康状况，并可能降低医疗保健支出。
