Managed care organisations (MCOs) enjoy a history of promoting health through preventive services and health maintenance activities. In this unique capacity as healthcare providers, these organisations can effect healthy lifestyle changes in their member populations.

The single most important cause of premature death and preventable illness, in the United States today, is cigarette smoking.1 Most individuals who smoke express a desire to quit.2 Through the implementation of smoking cessation programmes, MCOs can play a major part in helping motivated individuals to join the ranks of quitters.

As part of the Robert Wood Johnson Foundation initiative, Addressing Tobacco in Managed Care, an annual survey of all managed healthcare plans is being conducted each year from 1997 to 2000. These surveys have the following objectives.

• To assess the knowledge, attitudes and practices related to the Agency for Health Care Policy and Research (AHCPR) smoking cessation guideline3

• To monitor the status of efforts to incorporate tobacco prevention and cessation interventions into routine care

• To monitor the status of efforts to influence tobacco policies at the state, local or national level

• To identify barriers faced by managed healthcare plans in their efforts to address tobacco control

• To identify strategies used by managed healthcare plans to overcome barriers.

The results of the first annual survey are outlined here.