E-cigarettes: New challenge to smoking cessation coverage


Sometimes you just have to rip the Band-Aid right off--in one fell swoop. It may be scary, uncomfortable and even painful, but doing something right the first time often leads to positive results with less struggles.

Take smoking. If people want to stop smoking, it's probably better to stop breathing in the nicotine and numerous other toxins rather than swapping cigarettes for a not-as-bad version.

Unfortunately, it doesn't seem smokers agree because more and more people are picking up the habit of smoking electronic cigarettes, which contain no tar and less nicotine than traditional cigarettes. So they're not as bad as smoking traditional cigarettes but they certainly aren't kicking the addiction right to the curb.

The problem for payers, though, is that this growing trend--an estimated 700,000 people are currently using e-cigarettes to quit smoking--may actually be detrimental to their bottom lines and could even undermine their attempts to reduce smoking.

That's because the reform law allows payers to raise premiums on their members who smoke, but the provision doesn't apply to electronic cigarettes. So smokers who switch to these electronic devices could avoid paying higher insurance premiums.

What's more, although electronic cigarettes are marketed as a safer alternative to the traditional version, research is beginning to show this new trend may be just as harmful to smokers' health. While a better option to traditional cigarettes, the electronic versions still contain high levels of highly-addictive nicotine, which is linked to lung cancer and other breathing problems.

A study presented at the European Respiratory Society last year, for example, showed electronic cigarette users had lower oxygen levels in their bloodstream, which could dangerously affect people with coronary artery disease.

That means payers could be missing out on the added revenue the reform law allows them to incur while still paying for high medical costs that traditional smokers usually generate.

But what's a payer to do? One solution may be to better emphasize their own smoking cessation programs that use effective tools, such as nicotine gum, patches and nicotine replacement therapy, to help members stop smoking. That's the true goal here--for both payers and consumers--so why not highlight how beneficial and effective the programs can be?

It will definitely be challenging, but smoking cessation programs have proven effective at reducing smoking rates--and even recouping the costs of the program for payers. In fact, the Massachusetts Medicaid program recouped $3 for every $1 spent on a smoking cessation program for its members in only the first 16 months.

In other words, teach your members to rip that Band-Aid right off and stop messing around with nicotine altogether. It's worth it. - Dina (@HealthPayer)