Most insurance companies, and even the federal and state governments, do not fully cover behavioral and pharmacological treatments to help people quit smoking. But a new study shows that more than 100,000 fewer lives would be lost to smoking-related deaths over the next 20 years if full coverage was available for existing smoking cessation treatments.

The majority of the lives saved would be among older smokers, especially those in the 45-60 age group, because their death rate from smoking is particularly high. The savings in lives among older smokers would begin to accumulate a few years after cessation treatments were covered.

The study, which appeared in the peer-reviewed journal Tobacco Control, predicts that quit rates would increase to six percent annually if treatments were covered right now. The annual quit rate is currently about 4.5 percent.

David Levy, Ph.D., of the University of Baltimore, and Karen Friend, Ph.D. of Brown University, noted that an extra 1.5 percent of smokers quitting each year appears on the surface to be a small increase. But as the years go by, even such a small increase in the quit rate can add up to a significant number of lives saved. "Many older smokers, who would have otherwise died in just a few years, can be expected to live longer," they reported. "In 10 years, the total number of lives saved would be about 12,000, increasing to about 100,000 in 20 years."

As cessation treatments improve and more smokers begin to take advantage of the newer treatments, they predict that the savings in lives would be even more significant.

Their estimates are based on a computer simulation model called SimSmoke, which takes into account several factors, including the effectiveness of smoking cessation treatment; impact of smoking cessation on health; current use of available treatments; and current coverage for cessation treatment. The model also factors cigarette prices, restrictions on public smoking, and the current death rates among smokers.

Levy and Friend looked at a variety of coverage options for smoking cessation treatments, including physician intervention; intervention combined with prescription pharmacotherapy; over-the-counter drugs; behavioral therapy; and combinations of pharmacological and behavioral therapies. They concluded that the most flexible coverage, which allowed for the broadest coverage of treatments, would be the most effective at reducing smoking rates and death rates.

The current annual death toll from smoking without any additional coverage (beyond current levels) is estimated to be 418,317 lives. By 2010, the annual death toll without any additional coverage would be at 443,672. With full coverage for treatment, they predict that the death toll in 2010 would be 439,659, a drop of more than 4,000 that year alone.

By 2020, without insurance coverage for smoking cessation, the death toll from smoking would be 468,909. With insurance coverage, the death toll in 2020 would be 454,311, saving more than 14,500 lives that year.

SOURCE:
Robert Wood Johnson Foundation (http://www.rwjf.org)