Funding cuts: Short-term impacts already seen

Funding cuts: Short-term impacts already seen

The landscape of tobacco prevention and control in Washington state changed dramatically July 1, 2011 when all state funding for comprehensive programs ended. Based on the experience of other states, we can anticipate a forthcoming increase in tobacco use rates, causing more tobacco-related disease and health care expenditures. We don't yet know the scope of these long-term changes, but we've already seen short-term impacts. Some of these are detailed below. We'd like to hear how the funding cuts have impacted your programs -- see the end of this article for information on how to share your story.

Tobacco QuitLine services

Due to state budget cuts, the Washington State Department of Health's free Tobacco Quitline services ended in July. Prior to this cut, all residents of Washington state, regardless of insurance coverage, were able to talk to a Quitline professional. High-need populations (uninsured and pregnant women, among others) were eligible for additional services, including free Nicotine Replacement Therapy (the patch or gum, also called NRT). This service provided equitable tobacco cessation resources for all state residents.

The state budget cut eliminated this equitable service -- now, Quitline benefits are only available for certain populations. Statewide, those with insurance coverage for Quitline services (including some managed care providers and Medicaid) can still receive some level of service. Through March 2012, all King County residents can access the Quitline, but this is funded by a short-term federal grant.

The funding cut created a void in service availability for those with the greatest need -- including state residents without health insurance. In July, 559 state residents who called the Quitline were ineligible for services that had been previously provided. These individuals were ready to take a step towards quitting but were unable to receive the help they needed.

Despite the confusing patchwork of coverage, providers should still encourage their patients to call the Quitline to assess their access to Quitline services as some populations are still eligible.

Community Tobacco Cessation Partnership (CTCP)

State funding allowed the Tobacco Prevention Program to partner with community agencies, so that they could provide best-practice cessation services to their clients. These agencies included community health clinics and social service providers serving the homeless population and those with substance abuse and mental health disorders -- populations with some of the highest rates of tobacco use.

The CTCP included over 70 agencies, serving as many as 150,000 people. The Tobacco Prevention Program offered technical assistance and training to these agencies for tobacco cessation and in some cases, NRT that the agencies could offer to their patients.

Due to state budget cuts, the CTCP was eliminated, which means these agencies no longer receive technical assistance training or NRT. Their patients can call the state Quitline through March 2012, but many of these patients are unwilling or unable to utilize the Quitline.

One provider shared this anecdote with us about how the funding cut is impacting his work: "Not having the free NRT in the clinic has had a HUGE impact. I very rarely see patients now for smoking cessation, whereas when we had the NRT I was seeing several patients every week. I'm hearing the same from our other clinics. I don't know what people are doing now for smoking cessation, because most don't see me if there aren't patches involved. I suspect a lot are just trying to go cold turkey...which as you know is a much lower likelihood of success."

Upcoming survey

We would like to know how the funding cuts are impacting your or your agency. We have sent a survey to the agencies that used to be part of CTCP to help us collect information about the impact of funding cuts. If you did not receive this survey and would like to share your story with us, please contact Lindsey Greto at lindsey.greto@kingcounty.gov or 206-263-9410.