Extending the 5Cs: the health plan tobacco cessation index.

Objectives: To describe the smoking cessation services covered by licensed health plans in New York, and to evaluate plan characteristics that could account for variation in services.

Study Design: Prospective cross-sectional survey.

Methods: All 44 unique plans in the 2005 Managed Care Plan Directory of the New York State Department of Health were invited to participate. The Health Plan Tobacco Cessation Index was introduced to score each plan based on covered services, provision of counseling, capitalization of support for tobacco cessation, collaboration with the state quitline, and counting of tobacco users. Index scores ranged from 0 to 15, with higher scores indicating higher levels of cessation services. Descriptive statistics, analysis of variance, c2, and Fisher exact tests were computed.

Results: Of 35 respondent plans, 21 (60%) scored 10-the same as the Minnesota plan that recommended 5Cs for all health plans: Cover, Counsel, Capitalize, Collaborate and Count-or higher. Smaller plans had lower scores (P = .003). Seventeen plans promoted the state quitline.

Conclusions: New York plans compared favorably to a plan that features a model tobacco control program, but significant variation existed. There was room for improvement in collaboration with the local quitline.