In the State Capitol, everyone seems to have a lobbyist these days—except regular people. Take health care reform. The big players are working behind closed doors to put their stamp of approval on new legislation. Meanwhile working folks who need the attention of our lawmakers the most, risk being left behind.

Poorer Americans are more likely to begin smoking, more likely to be current smokers, and less likely to quit smoking. But smoking adversely affects the bottom line for us all. Californians are currently paying more than $8 billion annually in healthcare costs related to smoking. That’s more than $700 a year for every family. And businesses suffer from smoking too. Smokers spend eight percent of their workday on smoking related habits. The average smoker costs the employer more than $1,700 in lost productivity and more than $1,600 in excess medical expenditures, translating to more than $3,400 per year per smoker.

If policymakers are serious about cutting health care costs in order to expand access to health care, getting low-income Californians to quit smoking is a logical place to start. The smoking rates among California adults is 15 percent, but among poor families it’s about twice that.

Unequal access to evidence-based cessation treatment is a likely factor in low quit rates among the poor. The consequences of these low quit rates are clear. For African-Americans in particular, smoking and other tobacco use contributes to their leading causes of death—heart disease, cancer and stroke. And African-Americans have a higher prevalence and greater hospitalization rates due to asthma attacks which can be triggered by cigarette smoke.

The good news is that offering smokers help in quitting is as cost-effective as childhood shots and more cost-effective than treating widespread ailments like high-cholesterol. That’s why any health care reform package should include Assemblymember Dymally’s bill (AB 594) to require Medi-Cal to offer counseling and or all FDA approved smoking cessation medications to help smokers quit.

We know from research on the brain tells us that nicotine is one of the hardest substance use dependencies to break- just as hard as cocaine or heroin. What used to be known as a “habit” is now known as a true addiction. But according to US Department of Health and Human Services, 70 percent of smokers want to break their addiction, but fewer than seven percent who try to quit can remain smoke-free for 1 year thereafter.

African American smokers, about 70 percent of whom smoke menthol cigarettes, have disproportionately higher rates of smoking-related cancers and other diseases. Interestingly, some studies have even shown that nicotine intake per cigarette for African Americans is 30% greater than in Caucasians, perhaps because African-American smokers primarily use mentholated brands. Menthol flavored cigarettes comprise about one-fourth of all cigarettes sold in the United States. Because the menthol produces a cooling sensation in the throat, decreases the cough reflex, and acts to cover up the dry throat feeling smokers often experience, menthol cigarette smokers tend to inhale more deeply and hold the smoke in longer. People who smoke menthols are less likely to try to quit and are less likely to be successful when they do try.

A recent study by the President’s Cancer Council recommends that tobacco-cessation services and medications be a standard part of all health insurance. And according to the Centers for Disease Control and Prevention helping people quit is one of the most cost-effective health-care benefits available. Yet the media tends to ignore the issue of smoking cessation because helping people quit isn’t controversial and there is no quick fix. Smokers typically try to quit and fail at least six times before succeeding. The bottom line is most smokers actually want to quit- they just don’t have the help they need to overcome their addiction. As the Governor, Legislature and lobbyists debate health care reform, helping smokers reform should be their top priority.