Higher doctor pay proposed for smoking cessation help

Physicians in the US are currently poorly reimbursed for smoking cessation counselling. As a result, many invest little time in it, even when the health benefits are clear. Medicare, the US federal health insurer, wants to change this with a proposal to give doctors a 19 percent higher reimbursement for cessation counselling during regular visits. The same increase would apply to assessments of and interventions for alcohol and substance misuse.

Evidence exists; funding was missing

Medicare’s reasoning is straightforward: the effectiveness of cessation counselling as a preventive intervention is well-established. Smoking raises the risk of multiple chronic diseases strongly linked to accelerated biological aging, including cardiovascular disease, COPD, and several cancers. Stopping early measurably reduces those risks.

According to the proposal, the increase better reflects the clinical intensity and time investment of cessation counselling. The American Lung Association responded positively, calling the prioritisation of cessation support as a reimbursed service long overdue.

Not yet settled policy

This remains a proposal, not an adopted policy. Comments can be submitted until 14 September 2026. Whether it will be accepted unchanged is uncertain.

From a longevity perspective this is relevant: smoking accelerates biological aging through multiple mechanisms simultaneously, including oxidative stress, chronic inflammation, and telomere shortening. Better access to cessation support therefore touches on the prevention of accelerated aging at a population level. Whether the reimbursement increase will actually lead to more and better counselling remains to be seen in practice.

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