HAWAII received high marks from the American Lung Association in the battle against smoking, but joins most other states in neglecting to help people end their nicotine addiction. Health insurance programs need to include greater distribution of nicotine substitutes and counseling to make further progress.

The association's annual state-by-state assessment of tobacco control gives high marks to Hawaii for imposition of smoking restrictions in public places and its timetable for increasing cigarette taxes, which reached $2 a pack in September. In a new category, the association grouped Hawaii with 33 states that received “;F”; grades.

The grade was based on the coverage of cessation programs under Medicaid and state employee health plans, which varies. The ramifications among low-income people who qualify for Medicaid are tragic because their rates of smoking are nearly 50 percent greater than the general population.

State employees covered by the Hawaii Medical Services Association are offered nicotine patches and individual, group or phone counseling while those covered by Kaiser Permanente have access to nicotine gum and phone counseling only.

Randy Perreira, executive director of the Hawaii Government Employees Association, says trustees of the state Employer-Union Trust Fund “;have not seen fit to add that to health insurance coverage.”; He said he will ask legislators to include tobacco cessation programs in coverage of state employees.

Insurance leaders always have emphasized prevention as vital to health care. Such prevention is no where more needed than in helping smokers end their habit. Health plans in both the public and private sectors should include a wide array of tools to help clients free themselves from nicotine addiction.