The existing smoking prevalence has not significantly decreased in this country since 2004, demonstrating a stall in the previous seven-year decline. That so many are still smoking given the known dangers and the efficacious treatments available is a testament to the power of tobacco addiction and a strong signal that tobacco cessation services should be accessible and affordable for all tobacco users! That being said, I was very curious to know what, if anything, the current presidential candidates have incorporated into their proposed healthcare plans regarding tobacco cessation services. From what I was able to discern from the Brookings Candidate Issue Index, prevention, in general, and tobacco cessation, specifically, is not exactly a priority issue for two of the three candidates.
Senator McCain has almost nothing in the Prevention and Disease
Management section of his proposed plan other than encouraging “personal
responsibility to help prevent and manage chronic diseases.” McCain would encourage
businesses and insurance companies to promote and make smoking cessation
programs available since "most smokers would like to quit but find it hard to
He mentions that parents should impart to their children the importance of taking personal responsibility for their health, nutrition and exercise but does not even mention tobacco use. I could not find any indication of coverage for cessation services.
Senator Obama is a proponent of community-based prevention efforts which he claims diminish the smoking rates. He does, indeed, promote disease prevention. His plan addresses the fact that the four of the major chronic diseases in this country (heart disease, cancer, stroke, chronic obstructive pulmonary disease) result in over two-thirds of all deaths each year, but does not mention tobacco as the primary cause of these diseases! He seems to echo Senator McCain’s assertion that personal responsiblity for health is the answer. In fact, he asserts that “preventive care only works if Americans take personal responsibility for their health and make the right decisions in their own lives – if they eat the right foods, stay active, and stop smoking.”
The Obama health plan will require coverage of preventive services including smoking cessastion programs, but only in federally supported health plans, including Medicare, Medicaid, SCHIP and his proposed new public plan. As a former smoker himself, I am sure he realizes the importance of cessation interventions! I am a bit surprised he doesn't incorporate a more universal support for cessation services rather than limiting to those in a federally supported plan.
Only Senator Clinton has a clear declaration regarding smoking cessation services. Her plan even has a distinct paragraph addressing the need for cessation. Her plan acknowledges that “most smokers want to quit, but quitting is hard and they need more support. Yet states aren’t dedicating the necessary funds to anti-smoking programs - even though they received substantial funding from the tobacco settlements.” Senator Clinton will promote smoking cessation programs and fund them by increasing the federal excise tax on cigarettes and provide coverage for comprehensive smoking cessation in Medicaid. I applaud Senator Clinton. She should be acknowledged as the only candidate willing to take a firm stance on the importance of funding cessation programs.