the new smoking cessation imperative

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.

Introduction

Speakers

Gary B. Sams MS Chief Wellness Officer

Cameron Smith Regional Sales

Director

Learning objectives : To understand the facts of tobacco use

To review current trends in tobacco cessation

To review and discuss benefit plan and incentive program design issues

To understand resources available to support the development and delivery of effective tobacco cessation programs

maintain a healthy diet get enough exercise don’t smoke

The presence of just one healthy behavior compared with none cuts chronic disease risk in half. (CDC)

WE FOCUS ON WELLNESS ESSENTIALS

eatBetter moveBetter

breatheBetter

Company Background

The Tobacco Cessation Products and Services of beBetter Health

NRT Sales

Program Consultation & Evaluation

Web Based Programming

Marketing Support Coaching

beBetter products and services have helped millions address their challenges with tobacco use and nicotine addiction since 1977

According to the 2010 U.S. Surgeon General's report, 443,000 U.S. adults die from smoking-related illnesses each year. Smoking costs the United States $96 billion in direct medical expenses and $97 billion in lost productivity annually.

Source - Morbidity and Mortality Weekly Report (MMWR) Current Cigarette Smoking Among Adults — United States, 2011 November 9, 2012 / 61(44);889-894

Tobacco Use Facts:

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: Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 2012.

Employer Response:

Employer Response:

Workplace tobacco use policies Hiring and Personnel Policies Health Benefit plan design modification Employee Health and Wellness Programs

Recommended Reading www.no-smoke.org

Tobacco Cessation Programming Trends

Goals

Programs

Success

Incentives and Premium Differentials

Program Planning

Communication

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!

Tobacco Cessation Programming Trends

Tobacco Cessation Programming Trends

Types of Programs

On-site face-to-face coaching Web-based programs Texting & Mobile Telephonic coaching

Successful Programs

1. Participation 2. Quit Rate • Communication • Incentives • Vendor Selection

Tobacco Cessation Programming Trends

Recommended Reading TowersWatson 2011/2012 Staying@Work Survey report

Types of Incentives True premium surcharge or discount HSA or FSA Contribution Wellness Credits Premium Differentials Identifying tobacco users i. Affidavit ii. HRA iii. Biometric testing or Cotinine testing

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

Tobacco Cessation Programming Trends

Recommended Reading Centers for Disease Control and Prevention. Quitting Smoking Among Adults—United States, 2001–2010. Morbidity and Mortality Weekly Report [serial online] 2011;60(44):1513–19 [accessed 2012 Jun 7].

Communication

• 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

Tobacco Cessation Programming Trends

Legal Considerations

Individual state laws vary around smokers’ rights laws and lifestyle statutes

Just because it is legal to test for tobacco use doesn't 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

The Trouble with Tobacco Testing Human Resource Executive Magazine Online Jill Cueni-Cohen- Tuesday, October 9, 2012 Link: http://www.hreonline.com /HRE/view/story.jhtml?id=534354450

Recommended Reading

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

Results-Based Wellness Incentives How to Strategically Tie Your Wellness Program to A Benefit Plan Design with Premium Differentials An Industry Brief by beBetter Health, Oct. 2012 – available upon request www.beBetterhealth.com For additional information, see the DOL FIELD ASSISTANCE BULLETIN 2008-02.10 -Taken from the Department of Labor website

Recommended Reading

Employer Direct Costs Examples Greater health insurance costs and claims Greater life insurance premium costs and increased claims Greater disability costs Greater worker's 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

What’s the ROI?

Recommended Reading

Smoke-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: http://www.cdc.gov/tobacco/secondhand_smoke/00_pdfs/fullguide.pdf. Accessed: September 10, 2007. NBGH – Tobacco: The Business of Quitting- An Employers Website for Tobacco Cessation. Accessed: November 1, 2012

Workplace Costs of Tobacco Use

What’s the ROI?

Recommended Reading

1-“Making the Business Case for Smoking Cessation Programs” A report by America’s Health Insurance Plans. http://www.businesscaseroi.org/roi/apps/execsum.aspx 2-Stewart, WF, Ricci, JA, Chee, E, Morganstein, D. Lost productivity work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine 2003;45(12):1234-1246. ClearWay MinnesotaSM and Minnesota Department of Health. Minnesota Adult Tobacco Survey: Tobacco Use in Minnesota: 2010 Update. 2011

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

What’s the ROI?

http://www.businesscaseroi.org/roi/default.aspx

Employer Resources There are a tremendous number of resources available for employers who want to develop or improve tobacco cessation programs for their employees. Below are links to some of the most prominent organizations offering assistance.

Centers for Disease Control and Prevention – Smoking & Tobacco Use www.cdc.gov/tobacco/quit_smoking/cessation/index American Cancer Society Quit for Life Program www.acsworkplacesolutions.com/quitforlife.asp Fundamentals of Smokefree Workplace Laws www.no-smoke.org/pdf/CIA_Fundamentals.pdf Employers’ Smoking Cessation Guide: Practical Approaches to a Costly Workplace Problem www.endsmoking.org Tobacco: The Business of Quitting An Employer’s Website for Tobacco Cessation. www.businessgrouphealth.org/tobacco 1-800-Quit-Now www.smokefree.gov/quitlines-faq.aspx - http://betobaccofree.hhs.gov/

Employer Resources

www.breathebetter.me

This program is free for consumers and employers within basic set up parameters. Some fee for service features are available such as private labeling, telephonic coaching and special NRT options.

Thank You

For a copy of today’s presentation slides and additional resources, please visit: www.bebetter.com/hplive

For follow up information please contact: Cameron Smith Regional Sales Manager beBetter Health, Inc. 325 W. Huron Street Chicago, IL 60654 512.213.7910 cameron.smith@bebetter.net