Objective. To examine whether reimbursement for Provider Counseling, Pharmacotherapies, and a telephone Quitline increase
smoking cessation relative to Usual Care.
Study Design.
Randomized comparison trial testing the effectiveness of four
smoking cessation benefits. Setting. Seven states that best represented the national population in terms of the proportion of those >/=65 years of age and
smoking rate. Participants. There were 7,354 seniors voluntarily enrolled in the Medicare
Stop Smoking Program and they were followed-up for 12 months. Intervention(s). (1) Usual Care, (2) reimbursement for Provider Counseling, (3) reimbursement for Provider Counseling with
Pharmacotherapy, and (4)
telephone counseling Quitline with
nicotine patch. Main Outcome Measure. Seven-day self-reported cessation at 6- and 12-month follow-ups. Principal Findings. Unadjusted quit rates assuming
missing data=
smoking were 10.2 percent (9.0-11.5), 14.1 percent (11.7-16.5), 15.8 percent (14.4-17.2), and 19.3 percent (17.4-21.2) at 12 months for the Usual Care, Provider Counseling, Provider Counseling +
Pharmacotherapy, and Quitline
arms, respectively. Results were robust to sociodemographics,
smoking history, motivation, health status, and survey
nonresponse. The additional cost per quitter (relative to Usual Care) ranged from several hundred dollars to $6,450. Conclusions. A telephone Quitline in conjunction with low-cost
Pharmacotherapy was the most effective
means of reducing
smoking in the
elderly.
