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Medicaid Tobacco And Nicotine Cessation Treatment Rates Remained Low, 2019-24
Lisa Clemans-Cope1, Maya Payton2, Victoria Lynch3
1Lisa Clemans-Cope (lclemans@urban.org), Urban Institute, Washington, D.C.
Health Affairs (Project Hope)
|June 1, 2026
Summary
Few Medicaid enrollees receive tobacco cessation pharmacotherapy, despite high costs. In 2024, only 10.4% of daily users received medications, costing Medicaid $137.6 million.
Area of Science:
- Public Health
- Health Services Research
Background:
- Tobacco use incurs significant health and financial burdens on Medicaid programs.
- Pharmacotherapy is a key evidence-based intervention for smoking cessation.
Purpose of the Study:
- To estimate the uptake of cessation pharmacotherapy among daily tobacco or nicotine users enrolled in Medicaid.
- To quantify Medicaid expenditures on cessation medications.
Main Methods:
- Analysis of 2024 data on Medicaid enrollees using tobacco or nicotine products.
- Calculation of the percentage of users receiving cessation medications.
- Estimation of total Medicaid spending on these treatments.
Main Results:
- An estimated 10.4% of daily tobacco/nicotine users received cessation medications in 2024.
- Medicaid programs spent $137.6 million on cessation pharmacotherapy in 2024.
- State-level treatment rates varied widely, from 1.3% to 26.6%.
Conclusions:
- Current utilization of cessation pharmacotherapy among Medicaid enrollees is low.
- There is substantial room for improving access to and coverage of smoking cessation treatments within Medicaid.
- Targeted interventions may be needed to increase pharmacotherapy use and reduce tobacco-related healthcare costs.
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