Reduce Tobacco Use

The Issue

Smoking is the leading cause of preventable disease and mortality in the United States, resulting in more than $300 billion in health care costs and lost productivity and roughly 480,000 premature deaths annually.

The prevalence of cigarette smoking is especially high among certain groups of adults — including individuals in low-income populations, those with mental illness or substance use disorders, and Medicaid beneficiaries.

CDC’s 6|18 Initiative Success Story

Colorado: Improving Medicaid Tobacco Cessation Benefits.
Read more »  |  Other successes »


Plan an Evidence-Based Intervention

Following are tobacco cessation interventions identified by the CDC as having a proven evidence base for improving health outcomes and controlling health care costs:

  • Increase access to tobacco cessation treatments, including individual, group, and telephone counseling, and Food and Drug Administration – approved cessation medications (in accordance with the 2008 Public Health Service Clinical Practice Guidelines and the 2015 U.S. Preventive Services Task Force recommendations).
  • Remove barriers that impede access to covered cessation treatments, such as cost-sharing and prior authorization.
  • Promote increased use of covered treatment benefits by tobacco users.

Evidence Summary: Reduce Tobacco Use

Download the CDC’s evidence summary outlining key cost and health care information for payers and providers, as well as demonstrated outcomes for each of the above interventions.

Explore Implementation Resources

The following resources can help payers, state officials, and providers to implement high-opportunity tobacco reduction interventions. Does your state/program have resources to share? Send an email to

See also CDC’s smoking and tobacco use program web page.

Filter By:
Guide/Toolkit | June 2021
Describes questions to help determine health plans' abilities to cover tobacco cessation treatment.
Case Study/Profile | June 2021
Describes how two states, Kansas and Missouri, piloted use of the American Lung Association’s Guide to Assessing Tobacco Cessation Coverage in Health Plans and received preliminary results.
Brief/Report | June 2021
Identifies several common approaches that state tobacco control programs may consider when pursuing pharmacotherapy reimbursements in partnership with their Medicaid agencies and quitline service providers.
Case Study/Profile | October 2020
This spotlight outlines how Minnesota leveraged the 6|18 Initiative to ensure uniform implementation of expanded tobacco cessation benefits required by a 2015 state law that aligned tobacco cessation medication and counseling coverage with Affordable Care Act requirements.
Brief/Report | May 2020
Describes an innovative health care provider-targeted media campaign conducted by the New York State Department of Health's Tobacco Control Program
Journal Article | October 2019
Examines the results from New York State Department of Health’s media campaign to increase provider-assisted quitting that was implemented in 2016.
Case Study/Profile | September 2019
Showcases each state’s eligibility criteria, rationale, key considerations for making changes to criteria, how changes were implemented, challenges, and successes.
Case Study/Profile | September 2019
Highlight how three states have developed cost-sharing partnerships with Medicaid.
Engagement/Education Material | June 2019
Details promotional approaches for engaging the state’s health care professionals and Medicaid members in order to increase utilization of mechanisms supporting tobacco cessation.
Engagement/Education Material | June 2019
Assesses: 1) approaches and perceptions among providers that may influence uptake of tobacco cessation for their Medicaid patients, and 2) preferred tools and resources that may aid providers in supporting appropriate tobacco cessation interventions, including Medicaid coding/billing. 
Technical Assistance Tool | June 2019
Outlines specific measures that assess the impact of their communications campaign, specifically around the uptake of counseling and coverage benefits as well as the use of tobacco in the state.
Webinar | April 2019
Provides insight on state Medicaid benefits and coverage, as well as strategies to strengthen tobacco cessation and treatment efforts.
Brief/Report | December 2018
Examines the monetary value of programs or policies to determine whether the benefits from the program exceed its cost. In this case, WSIPP is looking at the benefit-cost summary of tobacco quitlines. 
Case Study/Profile | June 2018
Highlights Colorado's efforts to expand access to tobacco cessation medications and services and to increase communications around provider and consumer benefits.
Case Study/Profile | June 2018
Highlights South Carolina's efforts to improve access to and use of tobacco cessation coverage across its fee-for-service Medicaid program and Medicaid managed care organizations.
Guide/Toolkit | June 2018
Provides guidance on considerations for implementing cessation coverage, removing policies that act as barriers to treatment, and communicating clearly about the benefit.
Technical Assistance Tool | June 2018
Includes performance improvement projects related to: controlling asthma, preventing diabetes, controlling high blood pressure, and reducing tobacco use.
Technical Assistance Tool | June 2018
Shares sample questions compiled from surveys used by Medicaid and public health programs across the country to gather information about tobacco cessation benefits from MCOs.
Engagement/Education Material | May 2018
Summarizes web, text, and app-based tobacco cessation tools available to patients via the Smokefree platform.
Engagement/Education Material | May 2018
Details covered cessation services, eligible providers, billing codes for counseling, definitions of physician extenders, referral program information, and links to managed care organization contacts.
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