By the numbers:
$300 billion — Annual cost to U.S. of tobacco use
23 percent — Ohioans who smoke
$5.64 billion — Annual health care cost of smoking in Ohio
Sources: Centers for Disease Control and Prevention, Ohio Department of Health
Staying with the story
The Springfield News-Sun first reported on this story last year when Urbana resident Terry Levesque worked with federal lawmakers to close a gap in military retirees health coverage.
An Urbana man who fought to get military health coverage for a prescription to help him stop smoking is now concerned that no federal money has been set aside to pay for the program.
Terry Levesque began smoking cigarettes in boot camp when he started a 20-year stint in the U.S. Navy. He has tried quitting using lozenges, gum and counseling, but found the only one that worked was Chantix, a prescription medication.
Last year Levesque sought and received assistance from U.S. Sen. Sherrod Brown, D-Ohio, to change the law and fix a gap in military health coverage that prevented him from being reimbursed for the medication.
However no funding has been appropriated for the program, meaning at least for now, Levesque is still can’t receive coverage for the medication. He said he smokes about a pack a day now.
“It doesn’t last for a couple of seconds or a minute,” Levesque said of his craving during past attempts to quit. “It’s there and it’s constant.”
Statewide about 23 percent of adults in Ohio are smokers, a rate that’s slightly higher than the U.S. average, according to information from the Ohio Department of Health.
Health care costs directly associated with smoking are estimated at about $5.64 billion a year, about $1.4 billion of which is paid for through the state’s Medicaid program, according to the ODH.
Military members often suffer from the effects of smoking, including veterans, said Dr. Shannon Miller, acting director of addiction services for the Cincinnati VA Medical Center and an expert on smoking cessation programs. For several years, the military even included cigarettes in meal packages.
Levesque contacted Brown’s office after discovering the gap in his medical coverage through TRICARE for Life, a health insurance program for retired military members.
Once beneficiaries retire and meet age requirements, Medicare becomes the primary source of insurance and TRICARE for Life fills in gaps in coverage. But at the time, TRICARE for Life didn’t cover the reimbursements for FDA-approved smoking cessation drugs, meaning Levesque had to pay for those medications out of pocket.
Brown’s office highlighted Levesque’s case last year after drafting legislation to eliminate the gap and ensure reimbursement for FDA-approved smoking cessation drugs. The rule change has since been signed into law.
Brown’s office said in a statement they are now working with the Senate Appropriations Committee and the Department of Defense to pay for the program. They also recommended other avenues to receive at least partial coverage for the medication in the meantime, although Levesque said he has looked into those options and was told he doesn’t qualify.
Officials from the Defense Department couldn’t comment on Levesque’s specific case. But in a statement, they pointed to a section of the 2016 National Defense Authorization Act that expanded reimbursement of smoking cessation services for Medicare-eligible TRICARE beneficiaries.
“However, Section 713 states the refunds will be paid ‘subject to the availability of appropriations specifically for such refunds.’ As no appropriation has been received, TRICARE has not been able to implement this provision,” the statement says.
Levesque said he appreciated the law change but remains frustrated because he still can’t get his medication covered.
Quitting smoking isn’t impossible but real success is often elusive, said Miller, of the Cincinnati VA. As many as 85 percent of smokers try to quit at some point in their life and one-third of smokers try to quit every year.
But at the end of the year only about 3 to 5 percent are usually truly successful, he said.
“It is biologically in the form of a cigarette, the most addictive substance on the planet in terms of drugs of abuse, probably as or more addictive than crack cocaine or IV heroin,” Miller said.
The most effective treatments typically include a combination of methods, including therapy and nicotine replacements such as gum or patches. Drugs such as drugs like Chantix can boost the chances of quitting.
But many patients, even those who haven’t smoked for a year or more, can experience cravings and urges to smoke, Miller said.
Levesque said he will continue to push for more awareness of his problem in case other veterans face a similar issue.
“Whether it helps me or not I have no idea,” Levesque said. “But if it changes things where the word is out and veterans know it’s available maybe I’ve helped somebody out.”
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