Offering a smoking cessation benefit can improve the health of your employees and your bottom line.

By Stacy Kreps

Caring and cost-conscious employers have started adding smoking cessation programs to their employee benefits packages. They may be saving lives. According to a 2006 report from the American Lung Association, cigarette smoking is responsible for about one in five premature deaths in the United States.

How many employees light up? Approximately 18 percent of Kansans and 24 percent of Missourians smoke. Smoking also may be a problem if your organization has mostly younger employees. Every day, nearly 4,000 kids between the ages of 12 and 17 start smoking, according to the Centers for Disease Control and Prevention.

Cost to Business
A smoking employee costs almost $3,400 a year in increased medical costs and lost productivity. Smokers miss more days of work, have higher workers' compensation costs, more accidents and take more breaks than nonsmokers.

By encouraging employees to quit smoking, you help them lower the risk of serious illnesses, including cancer, heart disease and emphysema. An effective stop-smoking campaign also gives you a return on investment when it comes to health care and productivity. In its "Complete Guide to Creating a Smoke-free Workplace," the Kansas City, Mo., health department estimates that employers can save almost $1,000 per year in excess illness costs once a smoker quits. This doesn't include the indirect benefits from higher productivity and less absenteeism.

The problem is that despite the employee's desire to stop smoking, about 95 percent fail without help. Even with smoking aids, such as the nicotine patch or gum, the relapse rate is high.

Ready to Quit
In 1997, the FDA approved a non-nicotine smoking aid, which today is sold as Zyban or Bupropion. While this medication increased quit rates, most studies showed that over time, only 15 to 25 percent of smokers became smoke-free. Part of the difficulty in helping people stop smoking is that many relapse after successfully quitting for months or even years.

With these low success rates, employers may ask if it pays to offer stop-smoking help.

Recent initiatives show that the success rate increases dramatically when smokers get into a program that combines information, an understanding of "readiness" and the right kind of support.

Readiness is an important concept developed by James O. Prochaska and Carlo DiClemente. In their book, Changing for Good, they talk about the stages of readiness and how to help people find the motivation to change.

People in a local smoking cessation program, even those who have smoked for 20 years, responded well to telephone calls from registered nurses and licensed counselors trained in readiness concepts that included motivational strategies. During these calls, people often learned the root causes of why they started smoking in the first place. Information about relaxation and coping skills, combined with having someone to talk to about day-to-day stress, helped 46 percent of smokers in the program to quit. After three months, 42 percent were still smoke-free.

A Success Story
One program participant had smoked for 20 years and tried to stop many times without success. Like 70 percent of smokers, she wanted to quit but kept putting it off. Then her employer began a no-smoking policy and offered lower health premiums for non-smokers. These incentives motivated her to try again.

Through phone calls with a counselor, she learned that she smoked to relieve stress. Since smoking relaxed her, she had a lot of ambivalence about quitting. She also told us that her husband smoked. When he lit up in front of her, could she resist temptation?

To move through these obstacles, the counselor helped her deal with her ambivalence. One way is for the person to understand the risks. This woman had high blood pressure and a family history of heart disease. When she stopped smoking, her blood pressure went down and her doctor told her to stop taking her medication. This kept her motivated and today she continues to be smoke-free.

Her quitting had an unexpected benefit: her husband also quit.

Many similar programs seem to have high quit rates. A study reported in the American Journal of Industrial Medicine found that telephone contact resulted in a quit rate of almost 30 percent. The information, support and caring available from a qualified professional seems to make an enormous difference.

Your business can benefit from offering a stop-smoking program. The elements of an effective program include a no-smoking policy, an incentive such as lower health plan premiums, making quit aids available and, whenever possible, one-on-one assistance from a qualified professional.

Stacy Kreps is senior director of communications for New Directions Behavioral Health, which provides managed behavioral health care for several health plans and self-funded employer groups through organizational consulting, disease management and wellness programs. You can reach her at (913) 982-8200 or .