Include these two things for smoking cessation

Companies report up to 30% long-term quit rates

For your smoking cessation programs to be successful, there are two things you should address, according to new research from Indiana University (IU). A non-smoking spouse and smoke-free workplace play key roles in long-term success, according to results of the IU Smoking Survey, a 27-year longitudinal study of the natural history of cigarette smoking, housed at IU Bloomington's Department of Psychological and Brain Sciences.1

Because most smokers cycle through multiple periods of relapse and remission, tobacco dependence is like a chronic disease and should be treated as such, says Jon Macy, the survey's project director.

The study's findings have important implications for occupational health professionals, says Macy. "First, the smoking status of the spouse is important. So if a worker is trying to quit smoking, he or she is more likely to have long-term success if the spouse doesn't smoke," he says.

Occupational health nurses may want to consider offering couples smoking cessation counseling in instances where both partners smoke, Macy recommends.

Individuals whose workplaces were completely smoke-free were more likely to have long-term quitting success. "The smoking policy at the workplace is important," says Macy. "Occupational health professionals should be among the leaders in advocating for 100% smoke-free workplaces."

Smokers are hot topic

Tobacco cessation has been the hot topic for the last year, says LuAnn Heinen, director of the Washington, DC-based Institute on the Costs and Health Effects of Obesity. Nearly two-thirds of National Business Group on Health member companies recently surveyed offer stop-smoking programs as part of their health plans, which is a sharp increase from just 10 years ago when such coverage was rare, notes Heinen.

"Spending $900 for nicotine patches and counseling support can more than offset the estimated $16,000 or more in additional lifetime medical costs that a typical smoker generates," says Heinen. These costs don't include the cost of absenteeism or reduced productivity from smoking breaks at work, she adds.

It may take a few attempts before people are able to quit smoking for good, but many companies have reported long-term quit rates of up to 30% for good smoking cessation programs with counseling support, says Heinen. "It is now generally accepted that well-conceived smoking cessation programs will more than pay for themselves over time," she says.

Smoking and tobacco use is perhaps a greater cause of death and disability than the workplace environment, says Grace K. Paranzino, MS, RN, CHES, FAAOHN, national clinical manager of Troy, MI-based Kelly Healthcare Resources.

Factors associated with smoking that contribute to increased costs for employers include absenteeism, accidents, increased health and life insurance costs, actual health and life insurance claims, and workers' compensation payments, says Paranzino.

Individualize programs

Offer different programs targeting individuals who want to stop smoking, those who are not yet ready to quit smoking, and smokers who have successfully quit but need support to ensure success, advises Paranzino.

As part of your program, offer pharmacotherapies and individual, telephone counseling and group counseling, she recommends.

What works for one person doesn't work for all, cautions Paranzino. "Appropriate screening is therefore necessary to assess the readiness to change and match the employee with the appropriate smoking cessation program to increase the success rate of quitting," she says.

At Atlanta-based UPS, a Tobacco Cessation program launched in February 2007 is already yielding results, reports Judy Pirnie Smith, RN, the company's health and productivity manager. To date, more than 3,600 employees have enrolled, and 37% of those surveyed at the six-month point had quit smoking, says Smith. "We are thrilled with the initial results and hope more of our people will take advantage of this new program," she says.

When a UPS employee contacts the program, he or she is supplied with these resources, all supplied by Free & Clear, a Seattle, WA-based provider of tobacco cessation services:

  • Unlimited toll-free phone counseling sessions with quit coaches for ongoing support. "The coach will help them take the necessary steps to stop smoking or eliminate tobacco use, through a program tailored to that individual," says Smith.
  • integration with disease management, health plans, health assessment, wellness, and employee assistance programs;
  • phone-based decision support for the type, dose, and duration of medication, as appropriate, to help with withdrawal symptoms;
  • direct mail order fulfillment of nicotine replacement therapy timed with a participant's quit date;
  • printed, stage-appropriate "quit guides"
  • tailored motivational e-mails sent throughout the quitting process.

In addition to counseling and screening, occupational health professionals can provide another type of support to smokers, says Paranzino. "They can provide guidance to corporations to instill a culture that is conducive to positively impacting the health and productivity of workers, thereby reducing the health burden and economic impact of smoking," she says.


1. Macy JT, Seo D, Chassin L, et al. Prospective predictors of long-term abstinence versus relapse among smokers who quit as young adults. Amer J Pub Health 2007; 97:1,470-1,475.


For more information on smoking cessation programs, contact:

  • LuAnn Heinen, Director, Institute on the Costs & Health Effects of Obesity, National Business Group on Health, 50 F. St. NW, Suite 200, Washington, DC 20001. Phone: (202) 585-1825. E-mail:
  • Jon Macy, Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St., Bloomington, IN 47405. Phone: (812) 856-0840. Fax: (812) 855-4691. E-mail:
  • Grace K. Paranzino, MS, RN, CHES, FAAOHN, National Clinical Manager, Kelly Healthcare Resources, 999 W. Big Beaver Road, Troy, MI 48084. Phone: (248) 244-3894. Fax: (248) 244-4483. E-mail:
  • Judy Pirnie Smith, RN, Health and Productivity Manager, UPS, 55 Glenlake Parkway NE, Atlanta, GA 30328. Phone: (404) 828-6677. E-mail:

The Free & Clear Quit for Life Program provides tobacco cessation services, including telephone-based, one-on-one treatment sessions with a professional quit coach, decision support and fulfillment for appropriate medications, consulting for appropriate policies including premium differentials and smokefree workplaces, and data analysis to determine an employer's return on investment. Cost averages $365 per program participant. For more information including specific pricing, contact: Free & Clear, 999 Third Ave., Suite 2100, Seattle, WA 98104. Phone: (206) 876-2100. Fax: (206) 876-2101. E-mail: