Going Smoke-Free:Going Smoke-Free:the Cleveland Clinic examplethe Cleveland Clinic example

Bruce Rogen MD, MPHBruce Rogen MD, MPHChief Medical OfficerChief Medical Officer

Cleveland Clinic Employee Health PlanCleveland Clinic Employee Health Plan

Cleveland Clinic Background

Cleveland Clinic Cleveland Clinic CommitmentCommitment

Cleveland Clinic is dedicated to the Cleveland Clinic is dedicated to the health, wellness and prevention of health, wellness and prevention of disease for our employees, our disease for our employees, our patients and the communities we patients and the communities we serve.serve.

Health and Disease Health and Disease PreventionPrevention

Programming HistoryProgramming History

2005 2010

Smash the Ash

SmokeFree Greater Cleveland

Farmers Market

Chief Wellness

Officer

Go!Foods

Cigarette Use Decline Cigarette Use Decline 2003-20072003-2007

CuyahogaCuyahoga

OhioOhio

USAUSA

30

25

15

%

20

2003 2004 20072005 2006

Cleveland Clinic Bends Cleveland Clinic Bends the Cost Curvethe Cost Curve

• Increase efficiency through Increase efficiency through integrated healthcare delivery integrated healthcare delivery systemssystems• Reduce burden of disease by Reduce burden of disease by

addressing tobacco and obesityaddressing tobacco and obesity

Key tenetsKey tenets Key leadership must support and have Key leadership must support and have

strategy for moving forwardstrategy for moving forward

Incentivize positive changes; build Incentivize positive changes; build personal responsibility for healthpersonal responsibility for health

Importance of building a culture of Importance of building a culture of wellnesswellness

Importance of communicationImportance of communication• Media/Communications/Marketing Media/Communications/Marketing

teams must be ready to:teams must be ready to:- Notify personnel of the change and Notify personnel of the change and

how it effects themhow it effects them- Address the positive nature of the Address the positive nature of the

changechange- Develop a timetable for roll-outDevelop a timetable for roll-out- Respond to media inquiriesRespond to media inquiries

• 2005…All CC campuses declared non-smoking2005…All CC campuses declared non-smoking

• 2007…Hiring of smokers discontinued2007…Hiring of smokers discontinued

All new hires undergo cotinine testing. All new hires undergo cotinine testing. Positive test results…offer rescinded;Positive test results…offer rescinded;free treatment; reapply in 90 days.free treatment; reapply in 90 days.

• 2008…Free smoking cessation program 2008…Free smoking cessation program for Employee Health Plan members. for Employee Health Plan members.

• Only 8-10% of our current workforce currently uses Only 8-10% of our current workforce currently uses tobaccotobacco

Moving Toward Non-Smoking…

ResourcesResources

• For current employees:For current employees:- Tobacco cessation is covered by Tobacco cessation is covered by

employee health plan employee health plan - Also covered for dependents Also covered for dependents

• For the community:For the community:- Tobacco Treatment CenterTobacco Treatment Center- clevelandclinic.org/tobaccotreatment

• Insurance providers:Insurance providers:• Does your health plan cover behavioral Does your health plan cover behavioral

therapy, such as reading material, web-based therapy, such as reading material, web-based programs and individual or group counseling, programs and individual or group counseling, or non-traditional approaches such as or non-traditional approaches such as acupuncture or hypnosis for beneficiaries? acupuncture or hypnosis for beneficiaries? Their dependents?Their dependents?

• Does your health plan cover tobacco Does your health plan cover tobacco treatment medication such as Chantix, Zyban treatment medication such as Chantix, Zyban and Nicotine Replacement Therapy (NRT) and Nicotine Replacement Therapy (NRT) covered for beneficiaries? Their covered for beneficiaries? Their dependents?dependents?