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

Background
Tobacco use is the leading cause of preventable death in the United States. Although Medicaid covers tobacco cessation treatments, smoking rates remain much higher among Medicaid beneficiaries (30%) compared to those with private insurance (18%). This study examined how often South Carolina Medicaid fee-for-service beneficiaries received tobacco counseling from 2019 to 2022.

Methods
The study analyzed data from 49,401 individuals diagnosed with tobacco use disorder. It assessed differences in counseling rates by age, race, sex, region, and provider type using Chi-squared tests.

Results
Across all four years, Black and younger beneficiaries were less likely to receive counseling than White and older individuals. People living in rural areas were also less likely to receive counseling than those in urban areas, especially from 2019 to 2021. Additional differences were found by sex and geographic region in certain years.

Conclusion
Improving access to tobacco cessation counseling among Medicaid beneficiaries—especially in underserved and high-risk groups—is essential for reducing tobacco use and improving health outcomes.