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State
of Oklahoma: "The Sooner State"
www.health.state.ok.us
Total population: 3.5 million
Adult smoking prevalence: 26.7%1
Youth smoking prevalence: 24.0%2
Pregnant smoking prevalence: 18.1%3
Total funding for tobacco control in FY 2005:
$4.8M4
Proportion for tobacco cessation: 30% (about
$1.5 million)5
Cessation Services Profile
Quitline services: Reactive and/or Proactive
counseling for all callers. Medications are provided for uninsured
callers and Medicare callers not covered for cessation medications.
Medicaid coverage & services: SoonerCare
covers five first line pharmacotherapies over and above the
six prescriptions per month for which Medicaid participants
are eligible but does not cover counseling. (Counseling is
in legislative budget request.)
Health plan coverage & services: Some
health plans provide coverage but information is not available.
Key partners in tobacco cessation:
- Oklahoma Tobacco Settlement Endowment Trust
- Oklahoma State Department of Health
- Oklahoma State Medical Association
- Oklahoma Department of Mental Health and Substance Abuse
Services
- Oklahoma Hospital Association
Primary leadership:
- Oklahoma State Department of Health and Oklahoma Tobacco
Settlement Endowment Trust
Status of cessation program: We have done
an amazing job with only two full-time staff devoted to cessation
(the Cessation Systems Coordinator at the Oklahoma State Department
of Health and the Project Coordinator for the Smoke-Free Families
project at the Oklahoma State Medical Association). Additional
administrative staffs at the Oklahoma State Department of
Health, the Oklahoma Tobacco Settlement Endowment Trust, and
the Oklahoma State Medical Association devote a portion of
their time to this initiative.
We have a well-developed quitline, providing proactive counseling
for anyone who calls and providing nicotine replacement products
for uninsured counseling participants only. We still need
to work on providing specialized Helpline protocol and outreach
to specific populations. We have just added a separate phone
number for Spanish-speaking callers, but have not yet promoted
it. We are promoting the Helpline to health care providers.
We have focused our efforts on assuring that the Oklahoma
Tobacco Helpline is integrated into Health Department clinical
services, Department of Corrections facilities, Mental Health
and Substance Abuse clinical services, the Medicaid program,
and a few private health insurers. We have developed collateral
materials to promote the helpline among health care providers.
Once our Helpline was launched the SoonerCare (Medicaid) program
began covering pharmacotherapy for Medicaid participants.
Blue Cross/Blue Shield of Oklahoma is considering providing
coverage and Community Care HMO has been piloting coverage
of the pharmacotherapy benefit for their employees and spouses
of employees. They are considering providing coverage of pharmacotherapy
for their covered population.
We are in the beginning stages of expanding Helpline promotion
and cessation services within existing health services. The
Oklahoma State Medical Association has a Robert Wood Johnson
Foundation Smoke-Free Families project in which they are working
directly with a variety of physician practices to integrate
the 5A’s, including referrals and fax referrals to the
Helpline, for pregnant women who smoke. We have submitted
a grant proposal to the American Legacy Foundation to promote
the Helpline to Native Americans, African Americans, and the
Latino/Hispanic population. In addition we have obtained a
separate phone number for Spanish-speaking callers, and although
we have placed the number on our promotional materials, we
have not yet promoted the line to the Spanish-speaking population.
Key successes:
- Well-developed quitline
- Medicaid coverage
- Pilot program through Community Care HMO
- Initiative to promote Helpline to health care providers
- Integration of Helpline into Health Department clinical
services, Department of Corrections facilities, Mental Health
and Substance Abuse clinical services, the Medicaid program,
private health insurers.
Key challenges:
- Limited resources and limited staff
- Creative partnerships to help
Lessons learned:
- It is critical to work within the context of the overall
tobacco control program. Integrating cessation services
into any initiative to promote clean indoor air policies,
tobacco-free campus policies (including the campuses of
health systems and government organizations), tax increases,
or other policies to create behavior change, is essential
if we have any hope of gaining support from both tobacco
users and non-tobacco users. It is the humane and respectful
approach.
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1. Sustaining State Programs for Tobacco Control:
Data Highlights 2004, CDC
2. Sustaining State Programs for Tobacco Control: Data Highlights
2004, CDC (grades 9-12
3. CDC. Smoking During Pregnancy --- United States, 1990--2002.
MMWR 2004; 53(39);911-915.
Percentage of mothers who smoked during pregnancy by area:
2002
4. Campaign for Tobacco Free Kids. FY2005 Rankings of State
Funding for Tobacco Prevention: www.tobaccofreekids.org
5. MSA, general fund, CDC, ALF
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