Rhode Island Gov. Don Carcieri is proposing to cut the state's tobacco-control budget in half while requiring health insurers to pay for smoking-cessation programs and medication, the Providence Journal reported March 4.

Carcieri's plan calls for trimming the state antismoking plan from $2.2 million to $1 million, eliminating funding for treatment and cutting the program's advertising budget by $225,000. He says insurers should be made to cover treatment, and suggested that they offer premium discounts to smokers who quit.

"We're not cutting back, we're shifting it," Carcieri said. "If you really believe that this is the solution, long-term, for better, healthier people ... then the insurers have to get behind this."

Insurers said that only New Mexico and Maryland currently mandate coverage for smoking cessation. "For every mandate enacted by the legislature there is an increased cost to employers and health-plan members," said Debora M. Spano, a spokeswoman for UnitedHealthcare of New England. Blue Cross & Blue Shield of Rhode Island currently offers free smoking-cessation counseling by phone, and some plans include in-person counseling, as well.

Carcieri said that more than three-quarters of those using in-person cessation programs have private insurance, while most others could get counseling paid for by Medicaid.

Elizabeth M. Gemski of the American Cancer Society's New England division criticized Carcieri's budget cuts, and said that the insurance mandate should complement state-funded programs, not take their place. She noted that Rhode Island spends less than 2 percent of the $127 million in tobacco taxes it collects annually on smoking-cessation efforts.

East Bay Mental Health Center CEO Robert A. Crossley said there's also the risk that the budget cuts pass the legislature but Carcieri's insurance plan doesn't. "He's basically cutting funding with the hope that they will pick it up, but what happens if they don't?" Crossley said. "The risk is that, in the interim, people don't have access to the service."