Rhode Island proposes beefed-up coverage for smoking cessation treatments

Rhode Island has just proposed a regulation that would mandate insurance coverage for all tobacco cessation treatments recommended by the most recent clinical practice guideline, “Treating Tobacco Use and Dependence: 2008 Update.” As far as we can tell, this is the first instance in which this clinical practice guideline has been used as a basis for an insurance coverage mandate. If adopted, this regulation would put Rhode Island at the forefront of coverage for smoking cessation.

The proposed regulation and a concise explanatory statement can be found here.

Currently, the only tobacco cessation treatment for which health insurance coverage is mandated in Rhode Island is nicotine replacement therapy combined with 8 half-hour counseling sessions. The proposed regulation expands the coverage mandate to include smoking cessation treatments recommended by the most recent clinical practice guideline published by the United States Department of Health and Human Services. The Guideline provides an evidence-based path to tobacco cessation.

Updated most recently in 2008, the Guideline recommends the use of seven medications to treat tobacco use, including five nicotine-replacement-therapies (NRTs) and two other medications, bupropion (also known as Zyban) and varenicline (also known as Chantix). The Guideline also recommends three types of intensive cessation counseling: (1) individual (defined as face-to-face) counseling, (2) group counseling and (3) telephone counseling. Each type of counseling can be provided by any suitably trained clinician and is often provided by tobacco cessation specialists. While the Guideline states that either cessation medications or counseling therapies are effective on their own, treatments are even more effective when used in combination.

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