Fast Focus
	In 1999, the CDC estimated a smoker annually costs his employer an average $1,623 in excess medical costs.
	Quest Diagnostics saved millions when it made a big push to help smokers quit.
	To work, a program must be comprehensive and get upper management buy-in.

Nicotine Nation

Weaning workers off the nicotine habit cements business relationships and client savings.

By  Leslie Werstein Hann

Many group benefits brokers looking for ways to help their clients lower healthcare costs are overlooking low-hanging fruit: programs that help employees quit smoking.

If you’re thinking, “been there, done that,” think again. Paying for smoking cessation treatments is the single most cost-effective health insurance benefit for adults that employers can provide their workers, according to the U.S. Centers for Disease Control and Prevention.

While many health insurance and employee assistance plans offer some smoking cessation benefits, experts say they lack many of the components that are critical for success: comprehensive and affordable treatment options, powerful incentives, aggressive senior-management support and the ability to measure results.

In a 2007 survey conducted by the National Business Group on Health (NBGH), 85% of employers with 1,000 or more workers said they believe providing smoking cessation benefits to help employees quit or reduce smoking can be cost-effective for their company. Yet the survey also found that only 2% provide the comprehensive benefits that research shows produce the best results—and promise the greatest cost savings.

Savvy employee benefits brokers are capitalizing on the opportunity to help clients improve their healthcare claims trends with smoking cessation benefits and other wellness programs. Brokers who don’t offer a strategic approach won’t be able to deliver the results clients want to see.

“I would tell all the brokers in the world, ‘if you are not talking about tobacco cessation, you are really missing a big one,’” says Fred Williams, director of health benefits management at Quest Diagnostics, which provides diagnostic testing services worldwide. “They are missing a huge opportunity to help their clients improve the health of their employees, improve productivity and reduce costs.”

Williams talks from experience. For years, Quest’s 43,500 employees have had access to smoking cessation benefits through the company’s health plans. In 2005, however, Quest introduced an intensive health initiative called HealthyQuest, which addresses five major health areas. It was then that the company began to “affirmatively and aggressively approach smoking cessation as a benefit,” Williams says. The company contracted with Seattle-based Free & Clear to provide the “Quit for Life” program, which includes phone-based treatment sessions with a trained counselor, a tailored plan for quitting, and a free eight-week course of nicotine patches or gum. Employees also get prescription drugs that help smokers quit at normal copayments and a huge amount of workplace support—including a “smoking cessation leader” at every worksite. Sometimes the smoking cessation leader is a smoker, Williams says. “One person raised their hand and said, ‘I want to do it,’ who is going to help me?’”

Every person who lives in the employee’s household—whether or not a family member—is eligible for the Quit for Life program, and they can enroll once a year for as long as it takes to quit.

“The message is that if you are ready to quit, we are ready to help you,” Williams says. “We’ve learned it may take smokers five to seven times before they’re successful. We tell them if you are unsuccessful this time, you are still one step closer to being successful next time.”

The results have been impressive: Based on responses to the company’s health risk assessment tool, the percentage of tobacco users fell from 16.5% of employees in 2005 to 12.5% in 2007. By mid- 2008, the quit rate had risen to 47%—meaning almost half the smokers who tried to quit succeeded.