Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims

Abstract Background Tobacco use, particularly smoking, remains the leading cause of preventable death in the United States. While Medicaid in all states provides some coverage of tobacco cessation treatments, rates of tobacco use remain much higher among Medicaid beneficiaries (30.0%) compared to th...

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Main Authors: Kinsey Pebley, Joni D. Nelson, Julie L. Marshall, Alana M. Rojewski
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Substance Abuse Treatment, Prevention, and Policy
Subjects:
Online Access:https://doi.org/10.1186/s13011-025-00654-w
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author Kinsey Pebley
Joni D. Nelson
Julie L. Marshall
Alana M. Rojewski
author_facet Kinsey Pebley
Joni D. Nelson
Julie L. Marshall
Alana M. Rojewski
author_sort Kinsey Pebley
collection DOAJ
description Abstract Background Tobacco use, particularly smoking, remains the leading cause of preventable death in the United States. While Medicaid in all states provides some coverage of tobacco cessation treatments, rates of tobacco use remain much higher among Medicaid beneficiaries (30.0%) compared to those with private insurance (18.0%). The extent to which Medicaid beneficiaries receive cessation counseling services remains unclear. The current study assessed tobacco counseling occurrence among individuals who use tobacco among South Carolina Medicaid fee-for-service beneficiaries from 2019 to 2022. Methods Individuals with a tobacco use disorder diagnosis were identified (N = 49,401) and the differences in the number of patients counseled between demographic groups and the types of providers delivering counseling were assessed. Between-group differences in receiving counseling were assessed using Chi-squared tests. Results Fewer Black (χ2 = 34.54, 23.51, 8.54, 12.02, p < 0.5) and younger (χ2 = 81.43, 117.45, 83.25, 78.98, p < 0.0001) beneficiaries received counseling across all four years compared to their White and older counterparts, respectively. Additionally, fewer individuals in rural areas (χ2 = 12.44, 4.05, 5.07, p < 0.05) received counseling compared to those in urban areas in years 2019–2021. There were additional sex and regional differences in some years. Conclusions To improve cessation rates, focusing on increasing availability of cessation counseling services to Medicaid beneficiaries is critical.
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spelling doaj-art-1dba9546ea7e4c288751d17e8f6373782025-08-20T03:20:59ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2025-06-012011810.1186/s13011-025-00654-wTobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claimsKinsey Pebley0Joni D. Nelson1Julie L. Marshall2Alana M. Rojewski3Department of Public Health Sciences, Medical University of South CarolinaHollings Cancer Center, Medical University of South CarolinaDepartment of Community Health and Biomedical Sciences, Division of Population Oral Health, Medical University of South CarolinaDepartment of Public Health Sciences, Medical University of South CarolinaAbstract Background Tobacco use, particularly smoking, remains the leading cause of preventable death in the United States. While Medicaid in all states provides some coverage of tobacco cessation treatments, rates of tobacco use remain much higher among Medicaid beneficiaries (30.0%) compared to those with private insurance (18.0%). The extent to which Medicaid beneficiaries receive cessation counseling services remains unclear. The current study assessed tobacco counseling occurrence among individuals who use tobacco among South Carolina Medicaid fee-for-service beneficiaries from 2019 to 2022. Methods Individuals with a tobacco use disorder diagnosis were identified (N = 49,401) and the differences in the number of patients counseled between demographic groups and the types of providers delivering counseling were assessed. Between-group differences in receiving counseling were assessed using Chi-squared tests. Results Fewer Black (χ2 = 34.54, 23.51, 8.54, 12.02, p < 0.5) and younger (χ2 = 81.43, 117.45, 83.25, 78.98, p < 0.0001) beneficiaries received counseling across all four years compared to their White and older counterparts, respectively. Additionally, fewer individuals in rural areas (χ2 = 12.44, 4.05, 5.07, p < 0.05) received counseling compared to those in urban areas in years 2019–2021. There were additional sex and regional differences in some years. Conclusions To improve cessation rates, focusing on increasing availability of cessation counseling services to Medicaid beneficiaries is critical.https://doi.org/10.1186/s13011-025-00654-wSmokingSmoking cessationMedicareMedicaid
spellingShingle Kinsey Pebley
Joni D. Nelson
Julie L. Marshall
Alana M. Rojewski
Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
Substance Abuse Treatment, Prevention, and Policy
Smoking
Smoking cessation
Medicare
Medicaid
title Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
title_full Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
title_fullStr Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
title_full_unstemmed Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
title_short Tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the United States: an analysis of South Carolina medicaid claims
title_sort tobacco treatment billing and tobacco use disorder diagnosis in healthcare settings in the united states an analysis of south carolina medicaid claims
topic Smoking
Smoking cessation
Medicare
Medicaid
url https://doi.org/10.1186/s13011-025-00654-w
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