How to help your employees quit smoking

Breaking an addiction to nicotine isn't easy, but employers are uniquely positioned to encourage and help their employees quit smoking and vaping. Research shows that helping an employee quit smoking provides a great return on investment in lower health care and workers’ compensation costs and increased productivity. As November and the American Cancer Society's Great American Smokeout approach, this blog post can help you prepare for and promote your own companion program or Quit Day event.

With COVID-19, there’s also never been a better time to quit smoking. Smokers are more vulnerable to contracting COVID-19 and may suffer more severe symptoms. True, scientists are still learning about the disease, but they know that smoking tobacco impairs lung function and weakens the immune system, making it harder for the body to fight off viral infections and respiratory disease. The Surgeon General has published epidemiological evidence suggesting that smoking does indeed increase the risk of COVID-19 infection. For these reasons, the World Health Organization recommends quitting tobacco use.

The cost of smoking

In the U.S., tobacco use is responsible for one in five deaths. On top of that, for every death that results from smoking, an additional 20 people suffer from at least one serious illness related to smoking, including bronchitis, lung cancer, heart disease and stroke. Treating this population has a tremendous impact on employers and the health care system.

Smoking-related illness costs more than $300 billion a year in the U.S., including $170 billion in direct medical care for adults and $156 billion in lost productivity. For just one example, if employees take four ten-minute smoking breaks each day, they are working one full month less each year than employees who aren’t taking comparable breaks. When you add the increased use of health insurance plans to treat smoking-related illness, the annual cost of smoking to an employer averages $3,783 per smoker per year.

Why vaping isn't a good alternative

Some people looking to quit smoking may turn to electronic cigarettes, also known as e-cigarettes or vape pens, to help. But, these devices aren't a healthy solution to quitting, and haven't been approved by the Food and Drug Administration as smoking cessation devices.

While e-cigarettes likely contain fewer toxic chemicals than traditional cigarettes, vaping can still be responsible for severe health issues like lung damage, an increased risk of heart attack, and even death.

Vape pens are also just as addictive as traditional cigarettes. The myth that vaping is not as harmful as smoking is especially dangerous to kids and teens, who are vulnerable to addiction and the long-term health effects of nicotine use.

How to help your employees quit

Many employees want to quit smoking, but don’t know where to turn. Employers have many options to help their employees quit. For example, benefits administrators at many companies have introduced financial incentives for employees who quit or attempt to quit smoking. These incentives are successful and demonstrate the influence that employer policies can have on helping workers improve their health. The International Foundation Wellness Trends 2017 Survey Results showed that 59% of employers offered a smoking-cessation program and an estimated 16% of workers who smoke participated in them.

Here are 7 program ideas and resources you can use to make it easier for your employees to quit smoking.

1. Educate Your Employees

Perhaps the easiest and least expensive way to help employees quit smoking is to provide them educational materials through your corporate intranet or during a special campaign. Information online is abundant and free. Or for a small fee, you can download the American Lung Association's Freedom From Smoking.

This highly respected interactive guide:

• Addresses the difficulties of quitting with real-life advice, helpful activities and an innovative graphic approach that enhances learning
• Outlines methods to quit at the employee's own pace and on their own time
• Is available in English and Spanish
• Provides access to the American Lung Association Lung Helpline and online support community

For a more complete set of educational materials, take advantage of the comprehensive American Cancer Society Tobacco-Free Workplace Toolkit. This suite of resources can complement your company's own tobacco-cessation promotional efforts with prepared and customized e-mail blasts, newsletter inserts, direct mail postcards, brochures, posters, and personal testimonials.

2. Offer a comprehensive smoking cessation benefit

Ensure that your health plan providers offer comprehensive smoking cessation benefits. The most effective benefits cover proven treatment options with no out-of-pocket expense. If there are copays or out-of-pocket costs, consider picking up the tab. Removing cost barriers by providing 100% coverage for tobacco cessation medications and counseling increases utilization and long-term quitting success.

According to the American Lung Association, along with cost reduction, an effective smoking cessation benefit should:

• Cover all treatments recommended in the U.S. Public Health Service Guideline.
• Cover each medication for its FDA-approved duration of use.
• Cover at least four counseling sessions per quit attempt, and at least two quit attempts per year—more is even better.
• Waive prior authorizations, which slow down treatment and can decrease a smoker's motivation and momentum to quit.
• Waive mandatory counseling to obtain medications, which may discourage some people from seeking any assistance.

For example, AllWays Health Partners offers our members focused telephonic tobacco cessation counseling with a Certified Tobacco Treatment Specialist (CTTS) who:

• Assesses member smoking/tobacco habits
• Discusses quit methods
• Helps member develop a quit plan
• Gives information on medication
• Helps member work with their health care provider to obtain medication and other assistance
• Stays in contact with the member throughout the quit process

Members with our pharmacy plan also have a generous benefit for Tobacco Cessation medications including OTCs at no cost-share with a prescription from their provider

3. Establish a smoke-free worksite policy

Banning smoking on company property makes it more difficult for employees to smoke during the workday and may provide an incentive for some employees to quit. If you already have a tobacco-free policy in place, consider expanding the parameters to include your entire workplace property-- for instance, at building entrances, in company parking lots and while using company vehicles.

Benefits of a tobacco-free policy include:

• Demonstrates that the company cares deeply about employee well-being
• Eliminates wasted time on smoking breaks during work hours
• Helps managers by publishing clearly defined prohibitions that employees must respect
• Eliminates non-smoker complaints about air quality and lingering odors
• Prevents liability from lawsuits for exposure to second-hand smoke
• Preserves office carpeting and furniture from smoke damage
• Reduces fire risk
• Increases the possibility to negotiate lower health, life, and disability insurance coverage

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4. Participate in the Great American Smokeout

The American Cancer Society’s Great American Smokeout was inaugurated in 1976 to inspire and encourage smokers to quit for one day every November. It offers employers a great opportunity to encourage smoking employees to join thousands of smokers across the country in taking an important step toward a making a commitment to quit for good. Employers can tap into the program's free promotional materials and toolkits that can be tailored to the needs of each company.

The Great American Smokeout is often used by employers to launch a company Quit Day. This is a special day put on the company calendar to raise awareness about the risks of smoking. Activities on Quit Day can include:

• Holding a kickoff rally
• Providing free sugarless gum and bottled water
• Scheduling "non-smoking breaks" for everyone
• Promoting the National Cancer Institute’s "quitline" (877-448-7848)
• Scheduling smoking cessation experts to offer "How to Quit" workshops

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5. Promote smoking cessation support groups

Support groups are proven to help smokers quit for good. The most successful groups are led by certified professionals and focus on information and education. Some programs may be set up like classes, while others focus on sharing by members of the group. Some groups last a few weeks, while others go on indefinitely. Some are in person, while others are virtual. Two of the most respected support groups are Nicotine Anonymous and Freedom from Smoking.

Nicotine Anonymous (NicA)

NicA is long-standing peer help program that holds regular meetings and applies the 12-step program of Alcoholics Anonymous to tobacco addiction. People new to NicA may choose a sponsor to help them through the steps and when they are tempted to use tobacco. Meetings are free, but donations are collected to help cover expenses. NicA also has phone meetings, web meetings and online support.

Freedom from Smoking Clinics

Freedom from Smoking is a seven-week program run by the American Lung Association. Eight in-person group clinics are led by a certified facilitator in both English and Spanish. The program features a step-by-step plan for quitting smoking. Each session is designed to help smokers gain control over their behavior. Smokers who prefer a virtual support system can access Quit Now, a free online community moderated by AMA staff. Smokers can chat and connect with other quitters 24/7.

6. Promote smoking cessation "quitlines"

"Quitlines" offer good alternatives for smokers shy of joining a support group. Telephone counseling doesn’t require driving, transportation, or child care, and is available nights and weekends. It's also proven to work. People who use phone support have twice the success rate in quitting smoking as those who don’t.

1-800-QUIT NOW

All 50 states have quitlines with trained counselors who help smokers plan a quit method tailored to their unique pattern of tobacco use. Calling 1-800-QUIT NOW will connect callers directly to their state's quitline. Hours of operation and services vary from state to state. 

877-44U-QUIT

The National Cancer Institute’s trained phone counselors provide information and support for quitting in English and Spanish. Smokers can call Monday through Friday 9:00 a.m. to 9:00 p.m. EST or chat online with a LiveHelp information specialist to get immediate information and answers about quitting smoking.

800-LUNGUSA

The American Lung Association's Quitline is staffed by respiratory therapists and certified tobacco treatment specialists. They're available for any employees who want to learn more about tobacco cessation programs or need counseling from an expert. A Corporate Telephonic Program is a more formal option, providing a package of unlimited inbound calls, a customized quit plan, completion certificates, monthly utilization reports and subsidized Nicotine Replacement Therapy (NRT), such as patches, gum and lozenges at a reduced fee.

7. Enroll in "The Quit for Life Program"

A collaboration between Optum and the American Cancer Society, The Quit for Life Program is a smoking cessation program that has served more than two million tobacco users since 1985. Proven effective in multiple clinical trials, Quit for Life employs an evidence-based combination of physical, psychological and behavioral strategies to help participants overcome their addiction to tobacco.

A critical mix of phone-based coaching, text messaging, online learning, medication and support tools produces an average quit rate of 49%. An assigned account executive works closely with each employer to help develop a worksite policy, design a smoking cessation benefit, create promotional campaigns, and collect and report metrics on how the program is performing.

Even if a formal program is outside your company's capacity, anything employers can do to give workers a better chance of kicking the smoking habit can be worthwhile, from both a health and financial perspective. By providing support to help smokers quit, employers send the message that they care about their employees. That's a message we all want to hear during these trying times.