The demand for health insurance coverage for tobacco dependence treatments: support for a benefit mandate and willingness to pay.

One solution for reducing tobacco use is to expand health insurance coverage for tobacco dependence treatments (TDTs), but the public demand for a coverage mandate is unknown. This study finds that demand for coverage of TDTs among a random sample of adult Californians with employer-sponsored health insurance is strong, with 62% indicating that health insurers should be required to offer coverage as part of their standard plans and a majority (56%) indicating a willingness to pay $3 more for their annual health insurance premium to finance cessation coverage. Compared to never smokers, current and former smokers are no more likely to support a benefit mandate to require coverage of cessation treatments, but the adjusted odds are approximately three times greater that current and former smokers are willing to pay $3 more toward their annual premium to finance cessation coverage. Liberals had higher adjusted odds of supporting a benefit mandate and of being willing to pay a higher premium compared to conservatives. Non-whites had higher adjusted odds of supporting a mandate compared to whites, with no differences by race/ethnicity in willingness to pay a higher premium. There were no differences in preferences for a benefit mandate or willingness to pay a higher premium as a function of age, gender or income. These findings have important policy implications for a state health insurance mandate to cover tobacco dependence treatments.