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Improve Access to Cessation Treatment

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Cessation in WA

For Healthcare Providers

For Policymakers

For Coalition & Community Members
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Every person who uses commercial tobacco products should have access to affordable, effective, culturally and linguistically appropriate nicotine cessation strategies and support - especially when nearly 70% of people want to quit!

Commercial tobacco products contain nicotine, a drug that is very addictive.3 Nicotine traps people in a dependency cycle, even when they want to quit. Nicotine dependence and addiction should be viewed as a health condition to be treated, not as a personal choice or weakness.

Individuals who use a combination of counseling (like a quitline or group program) and medication (like nicotine-replacement therapy1) are more likely to successfully quit for good.2 A range of services need to be easily accessible and readily available.

Our Focus

Washington Breathes believes that the state must increase investment in evidence-based cessation strategies to equitably support all communities.

These cessation services should be accessible to all who seek treatment, responsive to individual and community needs, effectively promoted, and adequately resourced. The most effective cessation services are tailored to the specific needs of the individual and their community.

| Read our full Equitable Cessation Services Position Statement |

Access Quit Support

Important Note: E-cigarettes and nicotine vapor products should not be used for quitting. The FDA has not approved any e-cigarette as a safe or effective way to quit smoking.4

Data Snapshot

  • The WA State Quitline invested $0.35/user in 2021, compared to the national average of $2.28/user and the CDC minimum recommended amount of $3.73/capita.5,6
  • Four out of every nine adult cigarette smokers who saw a health professional during the past year did not receive advice to quit.8
  • Nearly 70% of people who use commercial tobacco products want to quit!8
  • Menthol is not just any flavor, it's a chemical additive that makes it easier to start using commercial tobacco products and harder to quit. Learn more in our Menthol & Nicotine Cessation Fact Sheet.

Cessation in Washington State

Washington State has received an F grade for many years in the American Lung Association’s annual analysis of overall access to cessation services.7 Quitting nicotine and commercial tobacco provides huge health benefits to the individual – as well as huge savings in healthcare costs. Despite these advantages, little funding is dedicated to providing comprehensive and evidence-based commercial tobacco cessation services for Washington state residents.

Priority Groups

Rates of commercial tobacco use and resulting tobacco-related diseases are higher in some populations. These groups are often targeted by the tobacco industry and also disproportionately impacted by a variety of adverse societal factors. Priority groups have been targeted by the tobacco industry based on:

  • race/ethnicity - such as marketing mentholated products to Black neighborhoods that make it harder to quit
  • socioeconomic status - through strategies like concentrating tobacco shops and convenience stores in lower income communities
  • gender identity and sexual orientation - through strategies like special product promotions to the LGBTQ+ community
  • age - including targeting youth with e-cigarette advertisements11

Because of these factors, these groups tend to have higher rates of commercial tobacco product use, while also experiencing more barriers to accessing cessation services. These barriers include not having access to services that are culturally appropriate or in their preferred language, relying on public insurance that doesn’t fully cover cessation services, not being advised to quit by a healthcare professional, and social pressure to use due to widespread community use.

Quitline Information

Washington State’s Quitline is a critical basic service that connects people to cessation services. Uninsured and underinsured Washingtonians are typically eligible for at least five counseling calls and two weeks of free nicotine replacement therapy (NRT), through CDC grant funding. However, many people need NRT support for longer periods of time to successfully end their nicotine dependence. Currently, the duration of free NRT products depends on available funding as well as the number of people requesting cessation support, which limits the program’s ability to help everyone who wants to quit nicotine.

Accessibility to Services

A robust and comprehensive tobacco cessation service should be easily accessible and as barrier-free as possible. Key factors to consider include physical location and ease of access (e.g. virtual/online offerings or integrated into existing health system), language (e.g. services available in a variety of languages), cultural considerations (e.g. ensure facilitator is familiar with the unique needs of the population being served), and cost (e.g. covered by health insurance or free of charge).9

Limitations to insurance coverage and costs are often a barrier to effective cessation services. Learn more about insurance coverage:

I’m Ready to Quit

We have compiled a directory of state and county-specific quitting resources for people who use commercial tobacco products and would like to quit.

Quit Support Services

For Healthcare Providers

All types of health professionals can play a critical role in connecting patients to cessation resources and counseling them on quitting. It’s important for all providers to stay up-to-date on best practices and to continue assessing all patients for nicotine dependence. The following are trainings, practice tools, and resources to support clinicians:

  • Tobacco Cessation Training Module (Public Health-Seattle King County): 90-minute, self-guided training ​​on using motivational interviewing techniques to encourage, empower, and assist people as they move toward a successful quit attempt. Email Nori de la Pena to register.
  • Ask, Advise, Refer to Quit Don’t Switch (American Lung Association): online training that gives providers tools and strategies for initiating a brief tobacco intervention and is based on CDC’s Ask-Advise-Refer model. Use the Registration link to sign up.
  • Practice Tools to Address Tobacco Use and Secondhand Smoke Exposure (American Academy of Pediatrics): information and guidance for pediatricians prescribing nicotine replacement therapy (NRT) to youth
  • Smoking Cessation Leadership Center (University of California San Francisco): webinars, publications, toolkits, and fact sheets/guides all available to providers
  • Accredited Programs to become a Certified Tobacco Treatment Specialist (CTTS) (Council for Tobacco Treatment Training Programs)

For Pediatricians:

For Dentists:

For Policymakers

Changes need to be made to improve accessibility and use of tobacco cessation services for all Washington residents. A few potential ways to improve cessation treatment include:

  • Restoring state investment in cessation services to better meet the needs of communities more impacted by commercial tobacco use.
  • Requiring health insurance companies to reimburse all providers for counseling and cover all seven (7) FDA-approved medications;
  • Ensuring health systems integrate comprehensive screening and treatment protocols, refer individuals to the WA State Quitline and other cessation services, and adopt tobacco-free campuses and policies;
  • Training providers and healthcare professionals to refer patients to the WA State Quitline and other cessation services, promote tobacco education and cessation campaigns, and seek additional training and certification.10
Our Equitable Cessation Services Position Statement
Improving Cessation in Your State

For Coalition & Community Members

Sources