Top 5 Takeaways

  1. Increased Comprehensive Coverage: From 2018 to 2022, states with comprehensive Medicaid coverage of tobacco cessation treatments rose from 15 to 20, while those without any treatment access barriers went from two to three.
  2. Significant Gaps and Barriers Persist: Despite improvements, many states still have coverage gaps and access barriers, limiting effective smoking cessation support for Medicaid enrollees.
  3. Public Health Implications: Enhancing Medicaid coverage of tobacco cessation treatments and eliminating barriers could improve health outcomes for smokers on Medicaid and reduce healthcare expenditures.
  4. Legislative Actions Drive Improvements: State legislative efforts, such as those in Ohio and Illinois, have played a crucial role in expanding coverage and reducing barriers, setting a precedent for future reforms.
  5. Medicaid Expansion Influences Coverage: The implementation of Medicaid expansion in several states has contributed to the improvement of cessation treatment coverage for standard Medicaid enrollees.

Original Article Author and Citation

Corresponding Author

Brenna VanFrank,

Suggested Citation

DiGiulio A, Tynan MA, Schecter A, Williams KS, VanFrank B. State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments — United States, 2018–2022. MMWR Morb Mortal Wkly Rep 2024;73:301–306. DOI: .


The article highlights progress in state Medicaid programs’ coverage of tobacco cessation treatments from 2018 to 2022, emphasizing the increase in states offering comprehensive coverage and those with no access barriers. Despite these advancements, significant gaps and barriers remain, underscoring the need for ongoing efforts to ensure barrier-free access to cessation treatments for Medicaid enrollees.


The American Lung Association collected state-level data on Medicaid coverage of nine tobacco cessation treatments and seven access barriers for standard Medicaid enrollees, analyzing changes in coverage and barriers from 2018 to 2022.


State legislative actions and Medicaid expansion have been instrumental in improving tobacco cessation treatment coverage. However, disparities in coverage and access barriers across states highlight the necessity for uniform, comprehensive coverage to support smoking cessation among Medicaid enrollees.


Enhanced Medicaid coverage for tobacco cessation treatments, combined with the removal of access barriers, is crucial for improving public health outcomes and reducing healthcare costs associated with smoking-related illnesses among Medicaid enrollees.

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