Tobacco Cessation

Project: 4.b.i. Promote Tobacco Use Cessation, Especially Among Low Socioeconomic Status Populations and Those with Poor Mental Health.

Alliance staff contact: Ed Stomski | 518.701.2283

Objective: Decrease the prevalence of cigarette smoking by adults 18 and older and increase the use of tobacco cessation services including NYS Smokers’ Quitline and nicotine replacement products.

Project Description: Tobacco addiction is the leading preventable cause of morbidity and mortality in New York State. Cigarette use alone results in an estimated 25,000 deaths in NYS. There are estimated to be 570,000 New Yorkers afflicted with serious disease directly attributable to their smoking. The list of illnesses caused by tobacco use is long and contains many of the most common causes of death. These include: many forms of cancer (including lung and oral cancers); heart disease; stroke; and chronic obstructive pulmonary disease and other lung diseases. The economic costs of tobacco use in NYS are staggering. Smoking-attributable healthcare costs are $8.2 billion annually, including $3.3 billion in annual Medicaid expenditures. In addition, smoking-related illnesses result in $6 billion in lost productivity. Reducing tobacco use has the potential to save NYS taxpayers billions of dollars every year.

Although there have been substantial reductions in adult smoking in NYS, some tobacco use disparities have become more pronounced over the past decade. Smoking rates did not decline among low socioeconomic status adults and adults with poor mental health. This project is targets decreasing the prevalence of cigarette smoking by adults 18 and older by increasing the use of tobacco cessation services, including NYS Smokers’ Quitline and nicotine replacement products.

Project Implementation Suggestions (from recent NYS Dept. of Health guidance):

  • Invite community partners to take part in planning the effort.
  • Review and include community recommendations from the Community Health Needs Assessment in plans.
  • Develop and adopt policies that support and enforce tobacco-free grounds throughout the Performing Provider System (PPS), including in community-based sites.
  • Develop and implement a policy to ensure treatment of tobacco dependence that includes:
    • Implementation or adaptation of an existing electronic health record (EHR) that captures and promotes screening and treatment at every encounter (outpatient and inpatient) and links to resources such as reference documents for drug interactions.
    • Implementation of workflow to optimize delivery of tobacco use screening and treatment.
    • Instituting for all health care team members routine tobacco use treatment training that covers the 5As.
    • Provision of counseling and optimal pharmacotherapy (as appropriate) at every visit.
    • Referring patients to the NYS Smokers’ Quitline (NYSSQL) as follow-up to on-site counseling and pharmacotherapy evaluation with bidirectional communication so providers receive feedback from referrals.
  • Increase Medicaid cessation benefit utilization by:
    • Educating patients on their benefit.
    • Offering both counseling and pharmacotherapy during each encounter.
  • Collaborate with participating health plans to identify value based methods for reimbursement for tobacco dependence treatment.
  • Provide feedback reports using quality measures for screening and treatment (including CPT II codes) to providers/clinics using the electronic health record.