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Pushing aid for smokers

Group urges more coverage to help people kick habit

By Joyzelle Davis, Rocky Mountain News (Contact)

Published August 9, 2008 at 12:05 a.m.

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At Denver's National Jewish Medical Center, Les Shapiro, 67, of Edwards, has his lungs tested. Shapiro, who is recovering from pneumonia, stopped smoking seven or eight years ago after one attempt. Colorado covers only one attempt per lifetime for Medicaid patients. A group of health care advocates says the state should cover two attempts per year.

Photo by Linda McConnell © News

At Denver's National Jewish Medical Center, Les Shapiro, 67, of Edwards, has his lungs tested. Shapiro, who is recovering from pneumonia, stopped smoking seven or eight years ago after one attempt. Colorado covers only one attempt per lifetime for Medicaid patients. A group of health care advocates says the state should cover two attempts per year.

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As most smokers and former smokers know all too well, quitting is rarely a one-and-done deal.

The average smoker needs at least three attempts to make a clean break, according to the Centers for Disease Control. Colorado covers only one attempt to quit tobacco per lifetime for the state's Medicaid population, although the CDC recommends funding two attempts per year.

A group of health care advocacy groups, including the National Association of Hispanic Nurses, the American Lung Association and the American Heart Association, is trying to raise Colorado's coverage to meet the CDC's recommendation. They wrote a letter to Gov. Bill Ritter late last month and are in discussions with the Colorado Department of Health Care Policy and Financing.

Smoking causes $1.3 billion in annual health care costs for Colorado, with Medicaid picking up $319 million of that, said R.J. Ours, lobbyist for the American Cancer Society in Colorado.

Smoking-caused productivity losses in the state amount to $992 million.

"When you look at the cost of (smoking-cessation programs) versus the long-term costs in health care for lung cancer or other chronic health diseases, it's a great investment to make in our public health," Ours said.

The Department of Health Care Policy and Financing is talking to the groups and gathering data and research to see if a policy change is in order, said spokeswoman Joanne Lindsay.

Medicaid covers roughly 400,000 Coloradans, although the majority are children.

Right now, Colorado pays for one 90-day smoking cessation program for Medicaid participants. The state also requires prior authorization and documentation of enrollment in a behavior-modification program.

Those two requirements make it difficult for some smokers to participate in a state-covered smoking program, said Catherine Benavidez Clayton of the National Association of Hispanic Nurses.

Tobacco use among Hispanic adults increased from 21.7 percent in 2001 to 22.8 percent in 2005, while tobacco use among blacks edged up from 17.9 percent in 2001 to 19.4 percent in 2005. Overall, roughly 17.5 percent of Colorado adults use tobacco.

At least 95 percent of people who try to quit on their own fail the first time, said Dr. David Tinkelman, vice president of health initiatives at National Jewish Medical Center, which runs the Tobacco Quitline for Colorado and four other states. The overwhelming majority of Coloradans who have called the six-year-old Quitline have tried at least twice, with 15 percent trying five to nine times and 11 percent trying more than 10 times.

"Nicotine is an addictive product, and the greatest barrier is the withdrawal. The cravings really get to them," Tinkelman said.

Most smokers want to quit. The CDC reports that 70 percent of adult smokers say they want to quit completely, and 44 percent tried at least once in the past 12 months.

"Smokers need to be ready to quit, and sometimes it takes five or six times to reach that readiness," Benavidez Clayton said.

Heavy toll

Tobacco use is the leading preventable cause of death in the U.S.

* 4,300 Colorado adults die each year from smoking

* Nationwide, cigarette smoking caused an estimated 438,000 deaths, or one of every five deaths - including 38,000 deaths from secondhand smoke

* $1.31 billion: the annual health care costs in Colorado directly caused by smoking

* $319 million: the portion covered by Medicaid

* $594: the per-household state and federal tax burden from smoking-caused government expenditures

Comments

  • August 9, 2008

    7:29 a.m.

    Suggest removal

    LOUIE writes:

    With the billion dollar tobacco settlement already blown by the states, maybe the billions in taxes tobacco generates, should go strictly to healthcare instead of political pet projects. The Tobacco man pays his keep, the politicians spend it on everything but healthcare. A very small portion was spent on education for smokers, that was for show. The majority was used to cover the politicians at the money trough. I like my cigars, smoke 2-3 a week, more than 3/4 of the price of tobacco goes to taxes. That's fair, just don't cry about it's costs when your spending this revenue on everything but tobacco related issues. The smoker gave you a ton of money for his habit, the tobacco company gave you billions of dollars in settlement funds, what did you do with the money? Colorado sold the future settlement funds like a lottery winner, spent a little on education, and used the rest for thier own political toys unrelated to tobacco. Now they come whining back with the same ole broken violin to play. Who's truly irresposible, the smoker paying billions in taxes, or the politicians who blows the wad on everything but healthcare. Tax on tobacco could almost pay for healthcare for those who are on the government dole now in this very important area of underfunded health programs. I'll strike up my Cohiba just like my 77 year old man still does. I'll pay big bucks for the priveledge. Please spend the revenue you make off me wisely; and quit whinning, your making billions of dollars off our habit. What do you do with this windfall of revenue?

  • August 9, 2008

    7:36 a.m.

    Suggest removal

    LOUIE writes:

    It's like paying the waitress for the fine dinner, but she never puts the money in the register, and trys to bill you again. They keep giving us a bill of what our habit cost, we keep giving them the money with a generous tip, and they keep coming back with the same bill. What do they do with the money? They don't put it towards our bill for sure, where does the billions in tobacco taxes go?

  • August 9, 2008

    7:43 a.m.

    Suggest removal

    Buckwheat writes:

    You guys are right on the money.. I'd like to see an accountability of all the money they've taken in, and what has been done with it.. They ya go RMN, or 9News Investigates. Where did my money go????
    Ex-Smoker

  • August 9, 2008

    8:19 a.m.

    Suggest removal

    LOUIE writes:

    Of the 438,000 deaths from tobacco cited here in this article, how many are old geezers like my 77 year old man, and how many are under the age of 60? Lets be realistic, when your pushing the envelope of age, smoking is just one of many things to consider. Makes a good arguement until you realize most of these deaths are people well into the twilight of life. I smoked ever since the state gave me tobacco in reform school, to include Colorado's Lookout Mountain. When Colorado shipped me out to Calfornia Youth Authority, Preston School of Industry, they gave us a little white pouch of tobacco with papers to roll, all this as a little kid. Today, well into my fifties, I workout every morning at 2 am., pump iron everyday, I benchpress 250+, I ride a bike somedays 20 miles or more. I swim, eat to excess, and I smoke the finest tobacco. I set the goal at 60 to be able to put my weight on a barbell and crank it up. I'm not saying smoking isn't harmful, what I am saying is there are many other contributing factors. Some people are physical wrecks regardless if they smoke. When thier guts are so big thier pee-pee is an old memory because it's no longer visable, or they lay around and let thier body go soft, smoking is the least of thier problem. I weigh 310 lbs. I am 6'6, some would say by the numbers I'm obese; but that's exactly how numbers are decieving. Thus if out of 438,000 deaths, if they are the majority over 60, maybe other factors need to be considered, not just tobacco. My last physical was great, other than cholesterol, I maintain my health well. Nobody lining up to chip my teeth today. If you take care of yourself, exercise like the bible, you just might put off bad health and be able to truly enjoy a cigar, fine foods, alcohol, and all the other pleasurable luxuries of life. Then there are those born genetically predisposed to bad health, to think Darwin borrowed heavily on the ancient thoughts concerning a master race through an evolutionary process. Some people just throw out bad genes, I thank God I was blessed to come from good stock. Make tobacco illegal, I have no problem bootlegging, I have to do it with my cigars now as it is. Be happy it's legal, government needs the revenue as it has a habit of spending itself broke; government needs to exercise financial restraint, and quit whinning when taking in billions from those they complain about.

  • August 9, 2008

    10:50 a.m.

    Suggest removal

    LOUIE writes:

    Suffer me to ask Jimminy; keep writting, I'll shut up and read...

  • August 9, 2008

    10:58 a.m.

    Suggest removal

    Buckwheat writes:

    "the health of the community trumps individual rights" OK, who determinds this, and what "rights" are we going to take away. I try to keep an open mind, but when someone starts talking about taking away someone's rights I get awful nervous. I need more info.

  • August 9, 2008

    11:08 a.m.

    Suggest removal

    anya writes:

    Worse than the smell of second-hand cigarette smoke is the smug generated by all of the do-gooders that just have to get themselves involved in the lives of others. Indeed, their dream is to use my and other taxpayers' money to do it.

    A few months ago, I read a study that said that, because smokers and obese people tend to die earlier, it is the fit people that exercise and take care of themselves that live longer and thus spend much much more for health-care in the long run.

    If someone wants to smoke, they should be given a certificate of thanks from the rest of us for dying early and leaving more for the rest of us. If someone wants to be a do-gooder, I hope they choke on their own smug.

  • August 9, 2008

    1:01 p.m.

    Suggest removal

    mover2 writes:

    I dont smoke and dont like it - but I live and work around people who do - and serveral younger smokers are not smoking or slowing down just do to cost.

  • August 9, 2008

    2:12 p.m.

    Suggest removal

    Buckwheat writes:

    And if everyone did quit, just where do you think the states are going to get their slush fund money from??? Also where do you think the billions given by the tabacco companies went? Certainly not for healthcare.

  • August 10, 2008

    9:19 a.m.

    Suggest removal

    jacka writes:

    Forget the extra coverage, encourage them to smoke more and die quicker.

    Second, reduce insurance coverage for smokers ... once they can't count on the rest of use to fund their oxygen then the next ones will have an incentive to quit on their own without extra help.

  • August 10, 2008

    4:08 p.m.

    Suggest removal

    Brix57 writes:

    I find it always quite interesting that on the extremely rare occasion that I actually go to a doctor, I find the waiting area packed with non-smokers with every imaginable complaint under the sun. Yet there are those that say that we smokers drive the health insurance industry costs sky high, even though numerous studies have shown that smokers tend to get sick less, lose less time at work and pay higher taxes than those non-smoking people around them.

    The article quotes "estimated" numerous times. It is an established fact that 41,000 people die each year from automobile "accidents", higher than those "estimated" second-hand smokers, yet nothing is done or said of that. This is merely another article using faulty math to consume space and scare the uneducated with numbers.

  • August 10, 2008

    7:28 p.m.

    Suggest removal

    LOUIE writes:

    Brix57, that's an intresting point I have yet to hear argued: Anyone know how many non-smokers are in poor health verse smokers, does that number exceed smoker substanially? Famine, deseases, Cerabal Palsy, MS, Downs syndrome, etc., verses the smoker, who's soaking the worlds medical systems the hardest? How much do non-smokers drain the healthcare systems verses the smokers? If so, statistics make a rather poor arguement when misused without further understanding. I believe the non-smokers rely heavily on those statistics without looking at other factors such as age, eatting, and exercice habits as well as genetic. Who constitutes the largest segment of world healthcare funds being spent, smokers or non-smokers? What is the real number one killer worldwide? Famine, genocide, desease, tobacco, what is the true number 1? It's nice to point at one thing when in fact there usually are other factors than tobacco to blame. Do you tax heavily these people who don't smoke billions of dollars a year for thier habits? Don't exercise, tax them. Obease, tax them. We can tax people just for being plain genetic foul ups. If they did pay, would you use the money on them for thier healthcare, or spend it on other things? The people through government, extract billions from the tobacco smokers and companies, yet they complain and greedily spend the money happily. Who's the real bum here, guy paying billions in taxes for his habit, or the ones who blows biilions in tobacco taxes and settlements on everything but that which he's complaining so loudly about, tobacco? I am begining to think one is bumming off the other who is paying enough in taxes to support a nationwide healthcare for all who have no insurance. It only costs under 25 cents to produce a pack of smokes, we're paying over 4 dollars a pack, how much is federal and state tax per pack? What are the greedly, money grubbing, complaining bums doing with that money? Smoker's not seeing a whole lot of it now is he? Who's the real panhandling bum here. For someone who hates smokers so much, they sure live well off us. Better hope the self-inflicted pain of the smoker doesn't end soon, the bums in government have already spent all the money they can tax out of the people, now they print paper, and give our debt to foriegn nations like China to hold. Non-smokers are just as much an irresponsible bum as the smoker and more so. In thier own right non-smokers relying on the sins of others, to pay thier bills, is every bit a bum's habit.

  • August 10, 2008

    7:45 p.m.

    Suggest removal

    LOUIE writes:

    If every American smoked, look at all that tax money; tobacco would save and make America strong again just like it did the colonies in trade. Sad thing is, even if every American smoked, even at 10 dollars a pack, with 9 dollars a pack tax, your government would still find a way to outspend itself, and put our nation in debt. Not one dime would go to the problem they're complaining about to get the added tax revenue. What good are health figures other than a means to raise taxes, especially if you never address the concern fully with all the revenue you generated from the campaign to raise the taxes? They cryed about tobacco cost on healthcare to get billions out of the tobacco companies, yet less than 10% collected was spent on tobacco related issues, why? Non-smokers are hypocrites or liars, or maybe just ordinary bums with thier own addiction to evil: money. They create the problems for which they can burden the people for more money, to spend on thier toys other than the problem thier complaining about. Need money to eat, but they spent it on a bottle instead; bums, where would America be without them.

  • August 10, 2008

    8:14 p.m.

    Suggest removal

    LOUIE writes:

    Colorado already sold off the tobacco settlement funds they were to recieve in the future; like a lottery winner. The money has all been spent on thier pet projects, it's gone; and the smoker is still smoking and paying his way with every pack he buys. Now the casino's, restaurants, and bars are going to pay the price for the crusade. Sad, America has spent itself broke and now must feed on thier own people. After the election, Colorado's politicians will again attempt to gut the TABOR and raise taxes, watch folks. Thier so drunk on the people tax money, the bartender is being attacked for shutting them off. Only reason Romanoff stopped his crusade last year, against the Taxpayers bill of rights, TABOR? It is an election year, and that's not too popular; democratic party powerbrokers shut him down. They need votes now, from the people they want to fleece. What a bunch of bums.