Problem/Objective: In July, 2006, new Health Care Reform legislation went into effect in Massachusetts. The reform included a two-year tobacco cessation pilot program to provide medications and counseling for the state's Medicaid subscribers. Each year, the Behavioral Risk Factor Surveillance System (BRFSS) includes questions aimed at defining a respondent's insurance status. This study will use the BRFSS to ascertain information about awareness of and use of the Medicaid benefit.

Methods: The Massachusetts Tobacco Control Program (MTCP) will conduct a followup survey of BRFSS respondents beginning in April 2007. This follow-up will be part of a larger attempt to validate the BRFSS insurance status questions and thus more accurately measure risk behaviors according to type of insurance.

Results: Three comparison groups will be assessed: (1) Medicaid members who do not smoke, (2) Medicaid members who smoke but have not used the benefit, and (3) Medicaid members who have used the benefit. Questions will include awareness of the benefit, whether health care providers asked about smoking status, referral for treatment, and any barriers to receiving treatments. Other survey questions will relate to quit attempts, use of pharmacotherapy and counseling and current quit status.

Conclusions: The methodology employed in Massachusetts may be a viable way to validate the BRFSS insurance questions as well as to ascertain whether respondents are aware of a Medicaid cessation benefit, have used the benefit, and encountered barriers to treatment. This population-based approach may provide a way for tobacco control programs to evaluate a cessation benefit and collect key information to inform advocates and legislators.