Best Practices for Tobacco Cessation in the Workplace The Basics and What’s New! Laura Loew Certified Tobacco Treatment Specialist President Smash the.

Best Practices for Tobacco Cessation in the WorkplaceThe Basics and What’s New!

Laura LoewCertified Tobacco Treatment Specialist

PresidentSmash the Ash!

(330) [email protected]

2014

Today’s talk will include:

• What is Tobacco Treatment?• Best Practices to help employees quit• Helpful resources • ACA guidance• Time for questions

• How many here are employers?• How many are brokers/insurers?• Vendors?• Any other categories?

• Anyone here a tobacco user? (It’s OK!)

A. . . What?

My Background:

• Ex-smoker! Began facilitating tobacco cessation programs 2007

• Tobacco Treatment Specialist Certification from Mayo Clinic, 2008

• Tobacco Cessation Coordinator, Medina General Hospital, 2007 - 2010.

• Pfizer physician trainer and Quit Clinic leader 2009 - present

• Smash the Ash! 2010 to present - Workplace Cessation. Lead a team of Certified Tobacco Treatment Specialists and other wellness advocates. Individual and group cessation programs, policies, health fair booths and educational sessions.

• Primary Prevention Chair, American Cancer Society, Medina, Ohio 2008 - 2013.

• Have personally helped over 875 people become tobacco-free and love what I do!

Tobacco use will claim one billion lives this century. World Health Organization

Half of all long-term smokers will die a tobacco-related death. Mayo Clinic

50%

One billion

Each smoker costs his/her employer $5816 per year more than a nonsmoker.

The Ohio State University, 2013

20,000

20,000 Ohioans die from tobacco-related illnesses every year American Cancer Society

$5,816

• Tobacco is the only product legally on the marketwhen, as used as directed, will kill half its users

• Most tobacco users start in their teens (some as young as 6 or 9 years old) when judgment and adult decision making is still years off

• Most people are truly addicted to nicotine

• Nicotine changes tobacco users’ brains

• Most people CAN quit. Maybe not easily, or maybe not the first time they try, but they can quit.

Tobacco Tidbits

• Cigarettes• Smokeless tobacco• Cigarillos - little cigars• E – Cigarette

• Hookah • Cigars• Pipes

Tobacco use I see:

My clients (workplace cessation). . .

• Employed adults

• “Healthy” users

• “Want” to quit?• Age 45 +

• Using tobacco for 30+ years

• Low SES (KEY to estimating tobacco use percentages)

• All races

• More men than women (60/40)

2 KEY WORDS. . .

Positive

And

Supportive!

Tobacco users probably already know WHY they should quit.

$$$ Health

Set a better example

Tired of it controlling them

Family/friends wantthem to quit

Their employer doesn’t allow smoking on their property or they pay more in insurance costs if insured

Tobacco users are looked down upon

Nicotine is one of the strongest addictive substancesBrain receptors release dopamine (DO THIS MORE!!!)

Need to treat addiction AND habit/behavior/stress management/coping (in a POSITIVE

and SUPPORTIVE manner) for highest longterm quit rates.

TOBACCO ADDICTION IS THE NATION’S NUMBER ONE HEALTH CRISIS . . .

And thus an employer’s number one chance to save money and improve the health of their workers.

They DON’T knowwhy is it so hard to quit. . . And neither does their employer.

Is Nicotine Carcinogenic?

7 First Line Therapies Approved by FDA

• NRT OTC (Patch, Gum, Lozenge/Mini-Lozenge

• NRT RX (Inhaler, Nasal Spray)

• Chantix (varenicline)

• Zyban (bupropion, aka Wellbutrin)

• Combination therapy, under guidance from CTTS, facilitates best quit rates

Support and Behavior

How many repetitions does it take to form a ‘habit’?

How many times have your employees reinforced their tobacco use?

Tobacco use is a ‘stress reliever’ but a low-effort coping mechanism.

Alternative “Treatments”

Acupuncture/Laser?

Hypnosis?

E-Cigarette?

Tobacco use is classified as a chronic, relapsingdisease. This is NORMAL!

You must make the quit attempt the BEST and therefore LASTattempt to quit.

Use evidence-based treatment plus support!

American Cancer Society

CessationBecomesThe Employer’s Burden

Why Onsite Group Cessation Works

• Easy and convenient for employees

• Replaces negative peer pressure with positive

• Credible program using outside experts

• Employees appreciate concern for their health (can’t get this benefit anywhere else)

• Competitiveness and accountability to group

• Uses recognized, evidence-based programs (PATH)

• FACE TO FACE is better. (This talk vs. webinar)

“But we don’t have a lot of smokers!”

General population in Ohio: 21% ‘smokers’

Hourly workers in Ohio: estimate 50-60% tobacco users

Epidemic of smokeless use: many dual users, switchers, or hidden users

“Our smokers don’t want to quit!”

CDC: 70% want to quit!

THEY PROBABLY DON’T KNOW HOW!

The ‘early adopter’. . .

“We already offer a telephonic or online program through our insurance company!”

How many tobacco users have called?

How many callers have quit? How are quit rates calculated?

Do they offer support for quitting smokeless tobacco?

Evidence-based program?

Using Certified Tobacco Treatment Specialists?

Onsite? Off-shift? CO monitoring?

NRT samples?

Ongoing support?

Options when Designing Workplace Tobacco Cessation Programs

Start with Lunch and Learn, or Health Fair Booth (non-threatening, lower investment)Onsite quit program – company pays. . and may hold classes on the clockOnsite program includes spouses and/or adult childrenDesignate a tobacco-free campus; have policy writtenCharge non and ex-smokers less for insurance (affidavit vs. testing)Pay for NRT and prescription medications for quitting. . . AND cessation classes. . . as many times as needed. Even if grandfathered.Don’t hire tobacco users?

I can't put a dollar figure on the savings. But I feel very confident that were are helping our employees live healthier lives. We demonstrated in a tangible way that the company cares about its employees. 

I think the most frequent positive comments that I heard were that staff felt the company cared about them by providing (paying for) the class. They thanked me personally. . . .The group format provided a built in support system, and some competition for those that respond well to that.

I was very pleased with the quit rate.  

Laura, your energy was the biggest key to the high success rate. . . You. . showed your level of caring about the class. They didn't want to let you down.

You rock!

Employer TestimonialMike Patalita, Site ManagerDo-it Best Corp, Medina

What are plans expected to provide as preventive coverage for tobacco cessation interventions?

The plan must cover, without cost-sharing:• Screening for tobacco use; and,• At least two tobacco cessation attempts per year. For this purpose, covering a cessation attempt includes

coverage for: • Four tobacco cessation counseling sessions of at

least 10 minutes each and• All Food and Drug Administration (FDA)-approved

tobacco cessation medications for a 90-day treatment regimen

Based on the Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008 Update

http://www.dol.gov/ebsa/faqs/faq-aca19.html

ACA Guidance

Association for the Treatment of Tobacco Use and Dependencewww.attud.org

www.treattobacco.net

American Cancer Society (free literature)American Lung Association

Tobacco-Free Kidswww.tobaccofreekids.org

Tobacco Cessation Leadership Networkwww.tcln.orgBringing Everyone Along (MH/SUD)

Resources for Tobacco Treatment Information

Legacywww.becomeanex.org

SmokefreeTxthttp://smokefree.gov/smokefreetxt

Mayo Clinic“My Path to a Smoke Free Future”

Kill the Can (smokeless quitting)www.killthecan.org

Nicotine Anonymous (check for local groups)

1-800-QUIT NOW

Resources for Tobacco Users

Thank you!

Questions? I am always available to meet with you to discuss my favorite topic! (no obligation!)

Laura Loew, CTTSSmash the Ash!(330) 636-6347

[email protected]