Helping seniors quit smoking: Medicare's wise policy decision

Medicare's intent to cover this intervention is applauded by medical groups and public health advocates.

Editorial. Jan. 31, 2005.

Sometimes people dismiss as unlikely the possibility that a lifelong smoker could want to quit. After all, someone's been at it for 40 or 50 years. Maybe that individual is simply too old to take such a step. And, even if it's possible, hasn't the damage already been done?

Absolutely not.

Both science and statistics show these lines of thinking to be wrong.

The Centers for Disease Control and Prevention estimated in 2002 that 57% of smokers age 65 and older reported a desire to quit. Currently, about 10% of them stop smoking each year. And the relapse rate among this population is only 1%.

And although many might think those older than 65 who kick the habit fail to reap health benefits, the U.S. surgeon general reported that even these quitters experience lower blood pressure, improved lung function and lowered risks for heart attack.

That's why a recent Medicare decision to provide coverage of tobacco cessation counseling to certain Medicare beneficiaries is especially meaningful. The American Medical Association was part of a coalition that supported the request for this expansion. Now the AMA, which has long-standing policy to advance anti-smoking efforts, and a multitude of other public health and medical organizations applaud the action.

The move is viewed as further evidence of Medicare's effort to become a prevention-oriented program. With this in mind, the AMA has reminded CMS that as this change brings more patients to their physicians' offices to stop smoking -- thus creating savings for the Medicare program in the long term -- the shorter-term costs of the increased utilization should not result in Medicare pay cuts.