Tobacco Cessation Coverage

Providing Federal Coverage for Cessation Services

The American Lung Association advocates for policies, laws and funding that ensure all tobacco users in the U.S. have access to evidence-based treatments that are proven to help them quit. One of the most important and major federal initiatives increasing tobacco cessation coverage is the Affordable Care Act (ACA).

All health insurance programs funded and run by the federal government should cover a comprehensive tobacco cessation benefit. Such federal programs include:

The American Lung Association also supports funding for tobacco cessation and prevention work through the Prevention and Public Health Fund and other means. One crucial federally-funded cessation program is the Centers for Disease Control and Prevention's Tips from Former Smokers mass media campaign, which has led millions of Americans to resources for quitting smoking.

Finally, the American Lung Association supports adequate levels of funding for the federal agencies that work in tobacco control and prevention, like the Centers for Disease Control and Prevention; and agencies that fund research on tobacco cessation, including the National Institutes of Health.

State Coverage

State Coverage for Cessation Services

The American Lung Association supports state policies that give smokers easy access to all treatments proven effective to help them quit. This includes:

Fully funding state tobacco control programs including quitlines
Providing a comprehensive, easily-accessed tobacco cessation benefit to all Medicaid enrollees and state employees, and through other state-run health insurance plans
Ensuring all private health insurance plans cover a comprehensive, easily-accessible tobacco cessation benefit

Factsheets & Reports

The American Lung Association’s repository for tobacco cessation policy materials, including factsheets and other helpful resources.

American Lung Association Reports

Closing the Gap: How Vermont Acted to Help More Smokers Quit This case study highlights how the Vermont Tobacco Control Program worked with state partners, including the state Medicaid program to improve the reach of the Medicaid tobacco cessation benefit by adding pharmacists as recognized providers.
Improve Access to Tobacco Cessation Treatment in North Dakota’s Medicaid Program: Efforts to Recognize Certified Tobacco Treatment Specialists This case study highlights the approach undertaken by the North Dakota project team, through participation in the CDC 6|18 Initiative, to recognize certified tobacco treatment specialists as qualified providers under North Dakota’s Medicaid Program.
Understanding the Coverage Landscape: A Case Study in Assessing Cessation Coverage This case study looks at the experiences of Kansas and Missouri, when they used the American Lung Association’s Guide to Assessing Tobacco Cessation Coverage in Health Plans. Using this tool, the states were able to under determine cessation coverage for various plans.
Tobacco Cessation Coverage in State Exchanges – 2020 This report looks at tobacco cessation coverage data in state exchanges. It contains state-specific public health information regarding coverage of the seven FDA-approved medications, three forms of counseling and barriers to access care.
Improving Tobacco Cessation Coverage through Medicaid Managed Care Contracting: Issue Brief This issue brief explores the ways state tobacco programs can collaborate with their state Medicaid agencies to improve coverage for tobacco cessation through either the Medicaid Managed Care procurement process or additional administrative mechanisms.
Indiana’s Standing Order for Tobacco Cessation: A Case Study This case study explores the implementation of standing orders in Indiana that allow pharmacists to dispense tobacco cessation medications to patients in the absence of a prescription from the tobacco user’s provider.
Implementing Tobacco Quality Measures through Medicaid Incentive Payments in Oregon: A Case Study This case study tells the story of Oregon’s innovative development of Coordinated Care Organizations and the utilization of quality measures and Electronic Health Records to implement a tobacco prevalence and cessation incentive metric. The collaborative work between the state Medicaid Office and the Public Health Division resulted in a comprehensive cessation benefit for all Oregon Medicaid enrollees.
Medicaid Expansion: State Tobacco Cessation Coverage This report looks at the thirty-five states and District of Columbia that have expanded their state Medicaid program under the Affordable Care Act. States are required to provide these newly enrolled individuals coverage of the essential health benefits, including preventive services. Tobacco cessation is a preventive service and is required to be covered for all Medicaid expansion enrollees without cost-sharing.
Improving Medicaid Tobacco Cessation Coverage in South Carolina: A Case Study in Partnership This case study tells the story of South Carolina's Medicaid Office and Public Health Department working together to expand their tobacco cessation coverage for the Medicaid population. Their work resulted in a comprehensive tobacco cessation benefit for Medicaid enrollees in South Carolina.
Comprehensive Medicaid Tobacco Cessation Coverage in Maine: A Case Study in Legislative Action to Improve Health This case study tells the story of Maine’s experience passing legislation to give enrollees in Medicaid near comprehensive coverage of tobacco cessation medications and services. It provides information on tactics and lessons learned during the campaign that should be helpful for other states seeking to do this.
Approaches to Promoting Medicaid Tobacco Cessation Coverage: Promising Practices and Lessons Learned This report explores the efforts promoting tobacco cessation benefits to Medicaid enrollees in five states. It offers different approaches taken by the states and the lessons they learned.
Medicaid Tobacco Cessation Coverage in Oklahoma: A Case Study in Leveraging Systems and Partnerships This case study explores Oklahoma's experience of designing and implementing near-comprehensive tobacco cessation coverage in Medicaid that has resulted in reductions in smoking prevalence and increases in utilization of cessation services, as well as other promising outcomes.
State Health Insurance Marketplace Plans: New Opportunities to Help Smokers Quit
Millions of Americans are now enrolled in health insurance purchased through marketplaces created by the Affordable Care Act (ACA). This newly insured population presents an opportunity to connect tobacco users with treatments that are proven to help them quit, yet this report finds that the coverage provided through state health insurance marketplaces is failing to give smokers all the help they need to quit, including access to all seven FDA-approved tobacco cessation medications required by federal guidance.
State of Tobacco Control
American Lung Association annual report that grades tobacco control policies, including cessation coverage, in each state.

State Factsheets

The American Lung Association tracks Medicaid coverage of quit tobacco treatments in all 50 states and Washington, D.C. Medicaid enrollees smoke at rates twice as high as their counterparts with private insurance, yet data shows they want to quit. Coverage of quit tobacco treatments without barriers to access can help them quit for good. Curious about what treatments are covered for Medicaid enrollees in your state? Did your state improve coverage or remove barriers to access since 2022? Click on a state below to find out more. For even more information about your state Medicaid program’s quit tobacco coverage and barriers to access, please visit our online database.

Historic Reports

Save Lives and Money: Help People on Medicaid Quit Tobacco
American Lung Association report released in conjunction with the Partnership for Prevention in July 2012. Explores why states should help people on Medicaid quit tobacco and what coverage is currently provided.
Save Lives and Money: Help State Employees Quit Tobacco
American Lung Association report released in conjunction with the Partnership for Prevention in July 2009. Explores why states should help their employees quit tobacco and what coverage is currently provided to state employees
Smoking Cessation: the Economic Benefit
American Lung Association and Penn State University Report released in 2010. Provides state-by-state return-on-investment information for covering tobacco cessation treatments.

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