Online Program

An update on the effects of tobacco cessation services on smoking rates among Massachusetts Medicaid recipients

Tuesday, November 5, 2013

John Gettens, PhD, Disability, Health and Employment Policy Unit, Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Monika Mitra, PhD, Lurie Institute for Disability Policy, Heller School of Social Policy and Management, Brandeis University, Waltham, MA
Alexis Henry, ScD, OTR/L, Disability, Health and Employment Policy Unit, Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Background: Massachusetts implemented Medicaid tobacco cessation services in July, 2006. Prior research using data from the Massachusetts Behavioral Risk Factor Surveillance System (BRFSS) survey reported a 26% decline in smoking rates among working-age Medicaid members in the 30 months following the implementation, suggesting the new services were responsible, at least in part, for the decline. We extend prior research using additional BRFSS data and new methods. Methods: We use logistic regression and propensity score techniques to adjust the smoking rate estimates for changes in the composition of Medicaid participants over time, and a differences-in-differences method to account for changes in smoking rates that would have occurred in the absence of the Medicaid change. These methods account for the expansion of health insurance coverage in Massachusetts which occurred simultaneously with the implementation of the tobacco cessation services. Results: Using these techniques and a longer time period, we are not able to fully corroborate prior research, suggesting that the short-term decrease in smoking rates among the Massachusetts Medicaid population previously reported may not occur over the long term. Conclusions: The long-term effects of the tobacco cessation benefit may be dependent upon relapse rates and continued high utilization. Future research on these topics is required.

Learning Areas:

Public health or related public policy
Public health or related research

Learning Objectives:
Describe regression and propensity score methods used to accommodate for group composition changes over time. Describe difference-in-differences methods to estimate program effects while accounting for the unobserved effects of time. Examine the use of BRFSS survey data for population-based Medicaid studies.

Keyword(s): Tobacco Control, Tobacco Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked extensively with survey data and have expertise in quantitative research methods. I conduct research on public health, healthcare and the employment of persons with disabilities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.