The American Cancer Society Cancer Action Network celebrated the 34^th Great American Smokeout on Thursday. So it's a good time to mention that Massachusetts has been quite successful in helping Medicaid beneficiaries quit smoking (as well as getting them insured).

As we have noted before,  while smoking rates have declined markedly in the past decade, tobacco remains the leading cause of preventable death in the U.S.. It kills more than 400,000 people each year and adds nearly $100 billion in health care costs.

The Center for Disease Control reports that while 20.6 percent of all adults smoke (16.0 percent in Massachusetts), 31.5 percent of adults living below the poverty line smoke. (And we know that the poor are less healthy to begin with.) Medicaid spends $22 billion annually on smoking-related health care costs. Specifically, each year, Massachusetts spends $3.54 billion on smoking related costs, and just over a quarter of that is covered by the state Medicaid program.

"Today, tobacco will kill more than 1,000 people, but we can reduce smoking rates," stated CDC Director Thomas R. Frieden, M.D., M.P.H in a press release this week.

Since July of 2006, MassHealth (the state Medicaid program) has offered coverage and easy access to smoking cessation programs to all its beneficiaries. The Massachusetts Tobacco Cessation and Prevention Program launched a widespread advertising campaign to kick off outreach efforts.

In just the past two and a half years, smoking rates for the Mass Medicaid population have dropped by a whopping 26 percent. State health officials report that this reduction in smoking is linked to fewer hospitalizations for heart attacks, fewer emergency-room visits for asthma and fewer maternal birth complications.

"The new Massachusetts results demonstrate once again that we know how to dramatically reduce tobacco use and its devastating toll in health, lives and dollars.  What's needed is a political commitment to implement proven solutions, including health care coverage for smoking cessation and aggressive, well-funded tobacco prevention and cessation programs," said Matt Myers, president of the Campaign for Tobacco-Free Kids.

The bad news? Massachusetts' budget for tobacco prevention and cessation has been reduced by 65 percent -- funding for 2009 is just  $6.1 million, falling way short of the $90 million suggested by the CDC. In light of health reform efforts, it is important that policy makers consider how these community-health programs can improve the lives and health of all Americans and move us toward a culture of health and wellness.

One last point -- health reform legislation pending in Congress would include Medicaid coverage for tobacco cessation programs for pregnant women, and include other programs to promote healthy lifestyles, in and out of Medicaid.