Smoking Cessation for Medicaid-Covered Pregnant Women

By: Kezia Ofosu Atta, Policy Manager, Groundwork Ohio

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The Prevalence of Smoking and its Effects on Ohio’s Mothers and Children   

While the percentage of mothers who smoked cigarettes during pregnancy has fallen over the past decade from 16.9% to 9.4%, this rate is still nearly twice the national average. Smoking cigarettes while pregnant has been associated with a range of adverse health outcomes for both mothers and their children. These include certain types of birth defects, prematurity, and linked to sudden infant death syndrome (SIDS) and congenital defects.

The smoking rate is even higher for pregnant women who are enrolled in Medicaid.  In Calendar Year2020,19.3% of Ohio mothers with Medicaid coverage smoked during pregnancy, compared to 2.2% of mothers not enrolled in Medicaid.   

To help states better understand how Medicaid can be used to address this preventable health risk, the Centers for Medicare and Medicaid Services (CMS) has released an informational bulletin on Strategies to Improve the Delivery of Tobacco Cessation Services.

CMS notes that most adults who smoke want to quit, but individuals enrolled in Medicaid are less likely to be successful in this quest. This suggests that Medicaid beneficiaries could benefit from increased access to and use of cessation counseling and medications.

CMS has recommended five strategies that states can use to improve the delivery of tobacco cessation programs and increase quit rates: 

• standardize and communicate covered cessation benefits across fee-for-service and managed care delivery systems 

• reduce barriers that make it difficult for specific populations, such as people with mental health or substance use disorders and pregnant women to access cessation services 

• use managed care contracts and quality improvement activities to improve the delivery of tobacco cessation services 

• partner with tobacco cessation quit lines and providers such as pharmacists to increase access to cessation treatments 

• establish partnerships to promote coverage and encourage utilization of covered cessation services 

Ohio Medicaid provides access to cessation services and the state funds some targeted smoking cessation initiatives through the Department of Health. The strategies promoted by CMS offer a more comprehensive approach to addressing the issue of smoking within the Medicaid population and come with federal matching funds to help Ohio dollars go farther.   

To improve birth outcomes, Groundwork Ohio encourages the state to adopt these strategies to further reduce smoking among pregnant women.