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Tobacco use remains the number one source of preventable morbidity
(illness) and mortality (death) in the United States. For employers, it
is also the single greatest cause of excess health care expenditures
and productivity losses. Tobacco cessation coverage is among the most
cost-effective health insurance benefits employers can provide. More
than 70% of smokers want to quit and attempt to do so each year, but
without help, most fail. Smoking cessation counseling and medications
are proven to help and effectively improve quit rates.4
Telephone-based
services are a convenient and effective way to provide information and
counseling; therefore, telephone-based cessation lines have quickly
become the most successful means of achieving tobacco cessation for
large populations, nearly doubling the chances that tobacco users will
quit successfully.
Quitline®
Overview
The American Cancer Society Quitline®
tobacco cessation
program was launched in May 2000 to expand services available to
smokers
-- specifically telephone cessation counseling. The American Cancer
Society has quickly become the #1 provider of Quitline®
services in the
United States, currently covering over 89 million people and serving in
excess of 280,000 callers since it began. Over 80,000 individuals
received services in FY 2007. The Society provides services to 12
states (Delaware, Florida, Kansas, Louisiana, Massachusetts, Michigan,
Nebraska, New Jersey, Pennsylvania, Texas, Vermont, and Wyoming), as
well as the District of Columbia (Washington D.C.). The Society also
contracts with over 90 commercial companies. In 2004, the Society was
awarded a grant to provide a Teen Quitline® in
North Carolina, targeted
towards an area of the state with high teen tobacco utilization. The
Teen Quitline program is now offered in several states. The Society
also worked with the American Legacy Foundation to launch Great Start,
the only nationwide Quitline® specifically for
pregnant women who
smoke. The Society has now implemented a similar program for all states
participating in the Quitline®.
The American Cancer Society's Quitline®
was developed based on
Public Health Service Clinical Practice Guidelines for Treating Tobacco
Use and Dependence. All counselors receive extensive training on Stages
of Change toward healthy behavior, a central feature of addiction
counseling. Also, the program emphasizes the principles of Motivational
Interviewing and Cognitive-Behavioral Therapy. Quitline®
counseling
also includes self-help-materials designed to help tobacco-users
effectively plan for their quit attempt and provide techniques proven
to reduce the likelihood of relapse. Finally, all callers receive a
follow-up call at 3, 6, and 12 months to evaluate the effectiveness of
counseling, as well as to reconnect them with Quitline®
services if
they have returned to tobacco use.
Employer Services
While Quitline® services are available
in many states, it is
difficult for national and multi-national companies to navigate the
complex web of local programs and refer their employees appropriately.
Furthermore, employers demand a return on investment for their efforts
to promote tobacco-cessation programs. For this reason, companies
across the nation are contracting with the American Cancer Society
Quitline® to tailor their tobacco control activities to the unique
needs of their employees.
The benefits of employee smoking cessation for the employer
are significant in two respects. First, in terms of health care
charges, smokers incur 18% more average annual health care expenses
than non-smokers. Second, in terms of workplace productivity, smokers
take more sick days (+2.5 days/year), more breaks, and are less
productive than non-smokers.
The benefits to employers of partnering with the Society to
promote tobacco control include:
- The ability to refer to a single telephone number for
tobacco-related questions and services
- Monitoring and reporting of
employee utilization and the effectiveness of employer promotional
initiatives
- Customization of tobacco-cessation services for
employees
- Evaluation results that quantify the number of employees
who quit as
a result of employer-sponsored tobacco-cessation programs, and allow
the company to track return on investment
- The Centers for Disease
Control have quantified that for every tobacco user a company helps to
quit, the employer will decrease health care costs by $2,325 (phased in
over a period of four years). They will also realize an improvement in
productivity that produces annual savings of $1,162 per quitter. This
amounts to a total return of $3,487 per quitter.7,8
For more information on Quitline® partnerships, contact us at acsworkplacesolutions@cancer.org.
References
1Warner KE. Cost effectiveness of
smoking-cessation therapies. Interpretation of the evidence and
implications for coverage. Pharmacoeconomics.
1997;11:538-549.
2Cummings SR, Rubin SM, Oster G. the
cost-effectiveness of counseling smokers to quit. JAMA. 2001;21:1-9.
3Centers for Disease Control and
Prevention. Trends in cigarette smoking among adults – United States
2000. Morbidity and
Mortality Weekly Report. 2002;51:642.
4Fiore MC, Bailey WC, Cohen SJ, et al.
Treating Tobacco Use and Dependence: Clinical Practice Guidelines.
Rockville, MD: U.S. Dept. of Health and Human Services, Public Health
Service; 2000.
5Pronk Np, Goodman MJ, O’Connor PJ, et
al. Relationship between modifiable behavioral risks and short-term
health care charges. JAMA.
1999;282:2235-2239.
6Hapren MT, Shikiar R, Rentz AM, et al.
Impact of smoking status on workplace absenteeism and productivity. Tobacco Control.
2001;10:233-238.
7Centers for Disease Control and
Prevention. Annual Smoking-Attributable Mortality, Years of Potential
Life Lost, and Economic Costs—United States, 1995–1999. Morbidity and Mortality Weekly
Report. 2002;
51: 300-303.
8Centers for Disease Control and
Prevention. Annual Smoking-Attributable Mortality, Years of Potential
Life Lost, and Economic Costs—United States, 1995–1999. Morbidity and Mortality Weekly
Report. 2002; 51: 300-303.
Revised: 11/14/2007
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