I’ve been telling my smoking patients for years that nothing I do for them is going to make an ounce of difference until they quit smoking for good. And the Italians are out to prove me right. The American Journal of Cardiology reported July 11th, 2011 on the Effect of Smoking Relapse On Outcome After Acute Coronary Syndrome.
In a study of just under 1,300 patients, Reuters reports that just over 1/2 the patients started smoking within 20 days of hospital discharge, despite in-hospital smoking cessation consultation for all patients. Researchers also found that resuming smoking increased death 3-fold compared with those that did not relapse and quitting smoking had a similar lifesaving effect as taking cholesterol and blood pressure medications. And I’m sure these folks all landed themselves back into the hospitals for a very expensive dying process.
That’s why billing the patient or their insurance for smoking cessation (CPT® 99406 and 99407) is so important. And that’s why I give many of my smoking patients my smoking lecture. You know how much Medicare pays for a ten minute consultation to help cardiac patients quit smoking right now? About $20. You know how much they pay for Plavix + Lipitor? Over $3,000 a year. At least they’re both going generic within the next 18 months.
Perhaps Medicare should pay more for more counseling and make patients who smoke pay more for their health care. That means higher copays, higher deductibles and higher out of pocket expenses for office visits, hospital stays and medication in smokers.
There’s no excuse in this day and age. If patients want the freedom to smoke, they should feel honored for the right to pay for the consequences, both with their health and their wallet.
*This blog post was originally published at The Happy Hospitalist*