Quittin’ Time: Helping Employees Become Tobacco-free

1. Quittin’ Time: Helping Employees Become Tobacco-free June 2005

2. Facts • Smoking reduces life span by an average of 12-14 years. • Tobacco use is the leading cause of preventable death in the United States and is responsible for one in every five American deaths. • Tobacco kills more Americans each year than alcohol, cocaine, crack, heroin, homicide, suicide, car accidents, fire and AIDS combined. • More than 50 diseases have been linked to smoking including cancers, heart disease and lung disease. • Each year, primarily because of exposure to secondhand smoke, an estimated 3,000 nonsmoking Americans die of lung cancer, and more than 35,000 die of heart disease.

3. Business Impact • The total excess costs to employers per smoker per year are an average of $5,606, broken down as follows: • smoking breaks: $1,882 • mortality-related lost productivity: $1,760 • excess medical expenditures: $1,623 • missed work days due to sickness: $341 • Although there is evidence that smoking cessation programs can reduce costs and improve health, only 24% of employers cover tobacco-use treatment. Companies that provide smoking cessation programs have a competitive advantage in the marketplace.

4. Nicotine Addiction • Nicotine is the drug in tobacco that causes addiction. • Nicotine is as addictive as heroin or cocaine. • Each year only about three to five percent of smokers quit for a year, for longer or for good.

5. Benefits of Quitting • People who stop smoking before age 35 avoid 90% of the health risks attributable to tobacco. Even those who quit at age 65 can add years to their life. • People who quit smoking before age 50 have half the risk of dying in the next 15 years compared with continuing smokers. • Quitting smoking decreases the risk of lung cancer, other cancers, heart attack, stroke and chronic lung disease. • Women who stop smoking before pregnancy or during the first three to four months of pregnancy reduce their risk of serious complications.

6. Opportunity More than 70% of current smokers report that they want to quit smoking.

7. Opportunity for Employers “There are few preventive health interventions that are more cost-effective than tobacco cessation.” -- Warner, K., et. al. cited in Business & Health, Vol. 15, #8, Supplement A, Medical Economics

8. Elements of Successful Cessation Programs • Supportive counseling – emphasizing problem solving, behavior change and social support • Nicotine replacement and medication – affordable, easy to obtain • Communication – inform employees of available resources • Incentives – may be provided in terms of reduced premium differentials, cash to a flexible spending account, even small rewards or recognition for quitting tobacco use

9. Elements of Successful Programs (cont.) • Integrated approach – integrate disease management and wellness programs, company policies, health plans and other workplace programs with available supportive counseling • No stigmatization of smokers – support employees in their efforts to become tobacco-free • Ability to access interventions repeatedly – repeated interventions are often necessary; policies and programs should support this process • A variety of resources – provide resources for individuals who are in various stages of readiness to quit

10. Prevention Goals • Influence tobacco users who have no desire to quit so that they consider the benefits of quitting • Provide support and assistance to those tobacco users who want to quit • Support former tobacco users in their efforts to remain tobacco-free

11. Strategy • Enlist support of senior leadership to ensure visibility and attention • Establish multi-functional workgroup • Design program • Craft and implement policy • Assemble support for tobacco cessation • Review employee benefits • Communicate and promote prevention through a series of materials, in print and/or online

12. Why Partner With the EAP? • prevention focus • assessment and referral capabilities • education focus • training capabilities The ValueOptions EAP is uniquely positioned to partner in the implementation of tobacco cessation programs because of its:

13. Service Options Offered by ValueOptions • Standard EAP: Evaluation and screening, short-term brief counseling and motivational coaching, information and education, telephonic support, referral to public/community resources, follow-up • Enhanced services: Telephone-based sessions with tobacco treatment specialists; Quit Kit of materials; access to nicotine-replacement products or medications

14. Possible Measurements of Program Success • Number of people recruited or actively participating in the tobacco cessation initiative • Six-month and one-year quit rates • Absenteeism rates • Productivity • Health costs

15. Expected Results • Decreased health care costs associated with tobacco use • Increased referral rate to the EAP • Enhanced productivity • Reduced absenteeism due to tobacco-related illness • Improved employee perception of employer commitment • Benefits of program exceed costs within two years of implementation

16. Next Steps • Obtain approval to proceed with evaluating options • Form multifunctional workgroup to study benefits, policies, supportive programming • Establish timetable for reporting recommendations to senior management • Obtain final approval to implement recommended plan • Implement plan

17. Sources • American Cancer Society • American Journal of Public Health • Centers for Disease Control and Prevention • Free & Clear, Inc. • National Business Group on Health • National Cancer Institute • The New York State Smokers’ Quitsite