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Tobacco Cessation Also Could Ease Smokers’ Diabetes

California is looking into a federal grant worth about $2 million a year that would establish an incentive wellness program that could help Californians give up tobacco — which potentially could have a strong effect on the health of smokers with diabetes, according to Neal Kohatsu, medical director of California’s Department of Health Care Services.

“Incentives are a great tool,” Kohatsu said at yesterday’s briefing in Sacramento on wellness incentives, an event co-sponsored by the two legislative health committees and The California Endowment. “Incentives are part of a larger picture of patient engagement,” Kohatsu said, “which we’re very interested in becoming more involved in.”

The grant money can fund projects that use incentives to alleviate chronic “lifestyle” medical challenges such as obesity, hypertension and diabetes. California has until May 1 to put a proposal together, and Kohatsu said the agency would like to focus on smoking cessation.

“It’s a pretty short timeline to develop it,” Kohatsu said. “We hope in a couple of weeks or less to get our proposal moving through approval process.”

Kevin Volpp, one of the nation’s leading researchers on wellness incentives,  spoke by teleconference at the briefing. Studies have shown that some health behaviors are easier to change than others — smoking, for instance, is easier to take on than obesity, he said.

“People would lose weight for as long as we paid them [in incentive rewards],” Volpp said. When they went back to their own ways, “they would regain the weight,” Volpp said. “It was very challenging. The lasting effect was not as good as we see in smoking cessation. Smokers tend to want to stay ex-smokers.”

That’s one reason California would like to create an incentive program around smoking cessation, Kohatsu said.

“Tobacco is the leading cause of morbidity from preventable diseases in California,” Kohatsu sadi. “And diabetes is, in part, impacted by smoking. We think it makes sense to target one, so it can help with the other.”

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