CDC: Adults who are Uninsured or Use Medicaid Smoke at Higher Rates than Insured Peers
A Centers for Disease Control and Prevention (CDC) study found that adults who are uninsured or on Medicaid smoke at higher rates than those who have private health insurance or are on Medicare.
According to data from the 2014 National Health Interview Survey (NHIS) about 28 percent of uninsured adults and 29 percent of Medicaid recipients currently smoke compared to about 13 percent of adults with private insurance and about 13 percent of those on Medicare.
Overall, the prevalence of cigarette smoking among U.S. adults dropped from about 21 percent to about 17 percent between 2005 and 2014, including a full percentage-point decline between 2013 and 2014 alone. Another major finding was that the average number of cigarettes smoked per day among daily smokers declined from about 17 percent in 2005 to about 14 percent in 2014 — driven by declines in the proportion of daily smokers who smoked 20 or more cigarettes per day.
The study found other differences in smoking rates consistent with previous studies. In 2014, prevalence of cigarette smoking was higher among these groups:
- Males (18.8 percent vs. 14.8 percent for females)
- Adults ages 25-44 years (20 percent)
- Multiracial (27.9 percent) or American Indian/Alaska Natives (29.2 percent)
- People with a General Education Development certificate (43 percent)
- People who live below the federal poverty level (26.3 percent)
- People who live in the Midwest (20.7 percent)
- People who have a disability/limitation (21.9 percent)
- People who are lesbian, gay, or bisexual (23.9 percent)
"These findings underscore the importance of ensuring that proven strategies to prevent and reduce tobacco use reach the entire population, particularly vulnerable groups," CDC's Brian King said in a statement. King is the deputy director for research translation in the Office on Smoking and Health.
Changes in the U.S. health-care system continue to offer opportunities to improve the use of clinical preventive services among adults. The Affordable Care Act is increasing the number of Americans with health insurance and is expected to improve tobacco cessation coverage.
Currently, neither private insurers nor state Medicaid programs consistently provide comprehensive coverage of evidence-based cessation treatments. In 2015, although all 50 state Medicaid programs covered some tobacco cessation treatments for some Medicaid enrollees, only nine states covered individual and group counseling and all seven FDA-approved cessation medications for all Medicaid enrollees. Cessation coverage is used most when smokers and health-care providers know which cessation treatments are covered.