The New Smoking Cessation Imperative
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  • 1. The New Smoking Cessation Imperative A review of current trends in programming, incentives and plan design November 16, 2012© 2012 beBetter Health, Inc. Confidential. Do Not Distribute.
  • 2. Introduction SpeakersLearning objectives : To understand the facts of tobacco use Gary B. Sams MS Chief Wellness To review current trends in tobacco cessation Officer To review and discuss benefit plan and incentive program design issues To understand resources available to support Cameron Smith the development and delivery of effective Regional Sales tobacco cessation programs Director
  • 3. Company Background WE FOCUS ON WELLNESS ESSENTIALS eatBetter maintain a healthy diet moveBetter get enough exercise breatheBetter don’t smokeThe presence of just one healthy behavior comparedwith none cuts chronic disease risk in half. (CDC)
  • 4. beBetter products and serviceshave helped millions addresstheir challenges with tobacco useand nicotine addiction since 1977The Tobacco Cessation Products and Services of beBetter Health Program Consultation Web Based Marketing NRT Sales Coaching & Evaluation Programming Support
  • 5. Tobacco Use Facts: According to the 2010 U.S. Surgeon Generals report, 443,000 U.S. adults die from smoking-related illnesses each year. Smoking costs the United States $96 billion in direct medicalexpenses and $97 billion in lost productivity annually.  Among daily smokers, the proportion who smoked ≥30 cigarettes per day (CPD) declined significantly, from 12.6% in 2005 to 9.1% in 2011, whereas the proportion of those who smoked 1–9 CPD increased significantly, from 16.4% to 22.0%.  Overall, among current smokers and those who had quit during the preceding year, 51.8% had made a quit attempt for >1 day during the preceding year.  Current smoking prevalence declined most markedly from 2005 to 2011 among adults aged 18–24 years (from 24.4% to 18.9%), and this age group, which had the highest prevalence in 2005, now has the lowest of any group aged <65 years. Source - Morbidity and Mortality Weekly Report (MMWR) Current Cigarette Smoking Among Adults — United States, 2011 November 9, 2012 / 61(44);889-894
  • 6. Employer Response:Source: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2012.
  • 7. Employer Response:  Workplace tobacco use policies  Hiring and Personnel Policies  Health Benefit plan design modification  Employee Health and Wellness ProgramsRecommended Reading
  • 8. Tobacco Cessation Programming Trends Goals Programs Success Incentives and Premium Differentials Program Planning Communication
  • 9. Tobacco Cessation Programming Trends Tobacco Cessation Program Goals Reduce health care & lost productivity costs Support tobacco-free campus policies Implement Tobacco Premium Differentials, Surcharges and Incentives Improve employee health!
  • 10. Tobacco Cessation Programming TrendsTypes of Programs On-site face-to-face coaching Web-based programs Texting & Mobile Telephonic coaching
  • 11. Tobacco Cessation Programming Trends Successful Programs 1. Participation 2. Quit Rate • Communication • Incentives • Vendor Selection Recommended ReadingTowersWatson 2011/2012 Staying@Work Survey report
  • 12. Tobacco Cessation Programming TrendsTypes of Incentives True premium surcharge or discount HSA or FSA Contribution Wellness CreditsPremium Differentials Identifying tobacco usersi. Affidavitii. HRAiii. Biometric testing or Cotinine testing
  • 13. Tobacco Cessation Programming Trends Programming Plan for Incentives • Timeline: offer tobacco cessation program 6 months to 1 year in advance • Tie premium differential/incentive to participation • Allow year-round opportunity for incentive • Clear communication strategy Recommended ReadingCenters for Disease Control and Prevention. Quitting Smoking AmongAdults—United States, 2001–2010. Morbidity and Mortality WeeklyReport [serial online] 2011;60(44):1513–19 [accessed 2012 Jun 7].
  • 14. Tobacco Cessation Programming TrendsCommunication • Carrot vs. Stick (reward vs. penalty) • Offer spouses support • Clearly communicate what needs to be done • Identify outbound calls to tobacco users • Support executive management
  • 15. Legal Considerations  Individual state laws vary around smokers’ rights laws and lifestyle statutes  Just because it is legal to test for tobacco use doesnt mean it’s the right thing to do  There are many complicating issues to consider, such as 2nd-hand exposure through family member use  The rising use of e-cigarettes  Consider alternatives and company culture Recommended ReadingThe Trouble with Tobacco TestingHuman Resource Executive Magazine OnlineJill Cueni-Cohen- Tuesday, October 9, 2012Link: /HRE/view/story.jhtml?id=534354450
  • 16. Legal Considerations (Wellness) The Five Criteria 1. Limited to 20% Differential 2. Must Be Tied to Wellness Programs 3. Annual Qualification 4. Provide Alternative Standards for Medical Exceptions 5. Disclose Alternative Recommended ReadingResults-Based Wellness IncentivesHow to Strategically Tie Your Wellness Program to A Benefit Plan Design with Premium DifferentialsAn Industry Brief by beBetter Health, Oct. 2012 – available upon requestwww.beBetterhealth.comFor additional information, see the DOL FIELD ASSISTANCE BULLETIN 2008-02.10 -Taken fromthe Department of Labor website
  • 17. What’s the ROI? Workplace Costs of Tobacco Use Employer Direct Costs Examples  Greater health insurance costs and claims  Greater life insurance premium costs and increased claims  Greater disability costs  Greater workers compensation payments and occupational health awards Employer Indirect Costs Examples  Recruitment and retraining costs resulting from loss of employees to tobacco-related death and disability  Lost productivity  Greater amount of work time used on tobacco-use habits and routines Recommended ReadingSmoke-free work sites top ten financial benefits to employers. Western CAPT/CASAT. University of Nevada, Reno.Center for Health Promotion Publications. The Dollar (and sense) Benefits of Having a Smoke-Free Workplace. Lansing,Michigan Tobacco Control Program; 2000.Centers for Disease Control and Prevention. Making your Workplace Smoke-Free: A Decision Makers Guide. Available at: Accessed: September 10, 2007.NBGH – Tobacco: The Business of Quitting- An Employers Website for Tobacco Cessation. Accessed: November 1, 2012
  • 18. What’s the ROI? Investments in smoking cessation save health plans and employers money in the short and long term. Research has shown that health plans investing $35-$410 to help a person quit over the course of a year generate positive return on investment (ROI) within 3 years. Simulation models using health plan data to estimate ROI for smoking cessation indicate that spending $0.18-$0.79 PMPM generates positive net ROI of over $1.70-$2.20 after five years. This model also demonstrates positive ROI for employers beginning in the first year that the investment was made and continuing over the five-year period. 1 Smoking cessation increases productivity. The American Productivity Audit, a national survey of over 29,000 workers, found that tobacco use was a leading cause of worker lost production time— greater than alcohol abuse or family emergencies. Quitting smoking improves a worker’s productivity.2 Recommended Reading1-“Making the Business Case for Smoking Cessation Programs” A report by America’s Health Insurance Plans., WF, Ricci, JA, Chee, E, Morganstein, D. Lost productivity work time costs from health conditions in the United States: Results from the AmericanProductivity Audit. Journal of Occupational and Environmental Medicine 2003;45(12):1234-1246. ClearWay MinnesotaSM and Minnesota Department ofHealth. Minnesota Adult Tobacco Survey: Tobacco Use in Minnesota: 2010 Update. 2011
  • 19. What’s the ROI?
  • 20. Employer ResourcesThere are a tremendous number of resources available foremployers who want to develop or improve tobacco cessationprograms for their employees. Below are links to some of the mostprominent organizations offering assistance.Centers for Disease Control and Prevention – Smoking & Tobacco Cancer Society Quit for Life of Smokefree Workplace’ Smoking Cessation Guide:Practical Approaches to a Costly Workplace Problemwww.endsmoking.orgTobacco: The Business of QuittingAn Employer’s Website for Tobacco -
  • 21. Employer Resources www.breathebetter.meThis program is free for consumers and employers withinbasic set up parameters.Some fee for service features are available such as privatelabeling, telephonic coaching and special NRT options.
  • 22. Thank YouFor a copy of today’s presentation slidesand additional resources, please follow up information please contact:Cameron SmithRegional Sales Manager beBetter Health, Inc.325 W. Huron StreetChicago, IL