Priority Population: Low Income & Medicaid (SES)

Socioeconomic status is the single greatest predictor of tobacco use. Medicaid clients and South Dakotans with lower incomes and lower education levels use tobacco at higher rates than the general population. They’re even at a higher risk because the tobacco industry increases advertising in low-income areas.

Medicaid clients are strongly encouraged to talk with their healthcare provider about free services they can receive. Healthcare providers can identify chronic conditions, explain how their tobacco use worsens those conditions, and refer them to resources to help them quit.

Tobacco Use Prevalence

• The Medicaid population smoking prevalence is 43% vs. the overall state rate of 19% (2013-2017).^ⓘ
• Medicaid enrollees are about twice as likely as the general US population to smoke tobacco: 32% of people in the program identify themselves as smokers.^ⓘ
• People living below the poverty level are more likely to smoke than those living at or above the poverty level.^ⓘ
• High use rate increases smoking-related disease, which is a major contributor to increasing Medicaid costs.^ⓘ
• Individuals with less than a high school education have higher incidence of lung cancer than those with a college education.^ⓘ
• Individuals with a family income of less than $12,500 have higher incidence of lung cancer than families with incomes of $50,000 or more.^ⓘ

Risk Factors

Multiple factors contribute to Medicaid enrollees being about two times more likely than the general population to be smokers.

The tobacco industry targets low-income neighborhoods.

• Low socioeconomic status creates stress. There is a strong relationship between commercial tobacco use and depression, anxiety, and stress.
• The tobacco industry promotes its products as a quick way to relieve tension from stress.
• Tobacco retailers are disproportionately located in low-income communities, which means community members face more exposure to tobacco marketing.^ⓘ
• Marketing in retail environments, including in-store advertising, discounts, and product displays behind checkout counters, is the tobacco industry’s main marketing channel.^ⓘ

Medicaid clients likely have more than one risk factor.

• Lower levels of education
• Increased exposure to secondhand smoke
• Unaware of services available to help them quit
• Experience housing and food insecurity
• Multiple chronic conditions, such as mental illness, high blood pressure, substance abuse, etc.

South Dakota Services for Medicaid Clients

South Dakota QuitLine

South Dakota QuitLine services are free and available to anyone 13 years of age or older. Medicaid clients can get help with quitting any type of tobacco product, including e-cigarettes.