Whether insurance coverage for smoking-cessation medicines increases quitting rates is uncertain. In this paper we evaluate the overall effect of a new health plan pharmacy benefit on the use of pharmacotherapy, attempts to quit, and quitting rates. The presence of a smoking-cessation pharmacy benefit as implemented by these health plans produced no change in the use of bupropion, nicotine patches, or nicotine gum, nor did it result in higher rates of quitting smoking. Further studies are needed to test whether greater efforts to make smokers aware of insurance benefits or adding other types of cessation support might lead to any beneficial effects.