Table 2.

Tobacco Control Activities by Size of Health Plan: 2002 Addressing Tobacco in Managed Care Survey (N = 152), United States

	⩽250,000 Members (N = 102) % Yes	>250,000 Members (N = 50) % Yes	P a
Plan has a written clinical guideline for smoking cessation	62.4	90.0	<.001
Plan provides full coverage for:
NRTb over-the-counter gum	3.0	8.0	.17
NRT over-the-counter patches	7.9	10.0	.67
NRT inhaler	42.6	22.0	.01
NRT nasal spray	42.6	22.0	.01
Bupropion (as Zyban)	47.5	28.0	.02
Bupropion (as Wellbutrin)	80.0	77.6	.73
Plan provides full coverage for:
Telephone counseling	62.4	30.0	<.001
Face-to-face counseling	52.5	18.0	<.001
Group counseling or classes	14.9	18.0	.62
Individual counseling of pregnant women	14.9	28.0	.054
Self-help materials	20.8	36.0	.04
Plan has annual or lifetime limits on coverage for smoking cessation interventions	17.0	28.6	.10
Plan allows patients to self-refer to smoking cessation services	68.3	40.8	.001
Plan requires providers to:
Ask new patients about smoking status	48.0	88.0	<.001
Include smoking status as a vital sign (i.e., ask about and document status at every visit)	39.2	85.7	<.001
Strongly advise all patients who smoke to quit	46.1	83.3	.001
Refer smokers to intensive treatment as appropriate	37.3	26.0	.17
Arrange for follow-up with patients trying to quit smoking	35.3	20.0	.054
Plan able to identify individual members who smoke	90.2	34.0	<.001
Plan has a specific strategy to address smoking cessation during:
Adolescence	5.9	76.0	<.001
Pregnancy	42.2	86.0	<.001
Postpartum visits (relapse prevention)	33.3	74.0	<.001
Pediatric visits (secondhand smoke)	5.9	74.0	<.001
Post-myocardial infarction	33.3	74.0	<.001
Treatment for other chronic illness	39.2	78.0	<.001
Hospitalization	3.9	14.0	.02
Plan has guidelines, protocols, or pathways to address smoking cessation during:
Adolescence	52.0	68.0	.06
Pregnancy	56.9	82.0	.002
Postpartum visits (relapse prevention)	46.1	68.0	.01
Pediatric visits (secondhand smoke)	48.0	70.0	.01
Post-myocardial infarction	50.0	72.0	.01
Treatment for other chronic illness	53.9	78.0	.004
Hospitalization	48.0	12.0	<.001
Plan funds a tobacco control program staff position	14.7	28.0	.05

^a Boldface indicates a significant difference.

^bNRT indicates nicotine replacement therapy.