State and Medicaid Tobacco Control Policies and their Association with Conventional and Electronic Cigarette Use, Quitting Behaviors, and Medicaid Spending on Cessation Products for Low-Income Smokers
Open AccessTobacco use is a leading driver of morbidity, mortality, and health disparities in the United States. In order to lower the prevalence of smoking, states have implemented several tobacco control policies and state Medicaid programs offer coverage for smoking cessation products and services to low-income enrollees who smoke; however, both state policies and Medicaid cessation coverage vary across states. This dissertation analyzes the impact of different state tobacco control policies as well as the comprehensiveness of Medicaid smoking cessation benefits on the use of conventional and electronic cigarettes and on conventional cigarette cessation behavior among a sample of Medicaid enrollees. This dissertation also assesses whether electronic cigarettes are predictive of conventional cigarette use or cessation. Overall, the findings from this dissertation indicate that electronic cigarette use is positively associated with the use of conventional cigarettes, especially among younger Medicaid enrollees and while electronic cigarette use significantly increases the odds of a smoker attempting to quit conventional cigarettes, it does not have a significant association with the odds of successfully quitting conventional cigarettes. On the other hand, comprehensive smoke free indoor air laws and increased spending on cessation pharmacotherapy by Medicaid are associated with higher odds of successfully quitting conventional cigarettes.
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