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Tobacco Cessation at Workplaces
Dr. Rakesh GuptaConsultant (India)Cancer Control Strategies- WorkplaceAmerican Cancer Society
Agenda
Background information- why tobacco users do not (cannot) quit but why workplaces should provide tobacco cessation
ACS India Workplace Solution for being smoke-free/ tobacco-free
ACS offerings for tobacco cessation
The basis for tobacco use
Why people get ‘hooked’ to it? The journey: Adventure to
addiction- The triggers: physical and psychological (person, place and time)
Inability to quit
o The Evidence- High relapse rateo The social reason- a nuance vs. disease;
o Ignorance and indifference of health professionals
o Lack of resources within the health system and workplaces
Evidence of Potential for Quitting
Annual cancer incidence and mortality
Incidence- decreased by 0.8% (1990- 2005); and, Mortality- decreased by1.8% (2002-05)
US Statistics • Former smokers vs. current smokers;
47 million vs. 43 million
"The most significant thing to talk about now is for people to stop smoking," he said. “There's nothing that comes close to it
in terms of direct impact on cancer rates." Dr. Len Lichtenfield, Dy. CMO, NHO, ACS
The economic basis for recommending tobacco cessation
Health care expenses: A smoker costs 18% more than a non-smoker1
Workplace productivity loss: +2.5 week days per year- more breaks and less productive2
Cost/s to an Individual if he does not quit (Rs.30 x 30x 12= Rs. 10,800); a case for salary deduction
1. Pronk Np, Goodman MJ, O’Connor PJ, et al. Relationship between modifiable behavioral risks and short-term health care charges. JAMA. 1999;282:2235-39.
2. Hapren MT, Shikiar R, Rentz AM, et al. Impact of smoking status on workplace absenteeism and productivity. Tobacco Control. 2001;10:233-38.
Quitting benefits:1. Short term;
2. Long term
The case for promoting wellness(tobacco control) in workplaces
Curative Healthcare- Incompleteness of Technology for Cure
Preventive Healthcare-Preventing Disease Completely
AGE Investment at younger
age has lower depreciation
on Health Capital vs. older age-
a higher depreciation and higher cost of cure
Workplace: A powerful setting for at-risk young employees
The choice
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Expense
ROI
The Industry standard for ROI- 3.15 times
ROIA well- designed Workplace WellnessProgram can reduce 25% of the health care cost, sick-leave, disability pay and worker’s compensation(Dallas Chamber Report, 2006)
A good case for business
P
C E
ACS approach to Comprehensive Employee Health & Wellness
Maximize Human ResourceThroughput
Corporation
Initiative #1: Tobacco-freeWorkplace
Initiative #2: Healthy andActive Workplace
Initiative #3: SociallyResponsible Workplace
1. Complete ban on tobacco use2 Freshstart & Quitline3. Communications4. Coverage for NRT & cessation medication
1. Caloric value on foods, subsidize healthyoptions, healthy catered food2 Active for Life /3. Communications4. Subsidize memberships to health clubs
1. Support local NGOs and community initiatives2 Employee giving / participation3. Communications4. Provide coverage for prevention and earlydetection services / screenings for chronic
Corporate Initiatives Comprehensive Solution Maps
Evidence Based Strategies: Tobacco-free Workplace
Targeted Employee Behavior
Benefits3 Policy1 EmployeePrograms2
Commun-ication1a
Tracking1b
Reduce / eliminate tobacco use among employees
Provide full coverage for tobacco cessation treatments: 1. prescription medications, 2. over-the-counter nicotine replacement therapy, and 3. Counseling
Ban tobacco use at worksites
Sponsor a tobacco cessation program including Quitline; sponsor nicotine replacement therapy
Conduct targeted health promotion campaign focusing on key health behaviors
Survey employees’ health behaviors to track effectiveness of health promotion effort
The ACS India Workplace Solutions:Tobacco Cessation
Quitline- the telephone based counseling
Freshstart- the on-site program
Others:Tobacco Cessation Clinics Project- MOH & WHOPharma coordinated network of cessation clinics
Cessation Clinics under National Tobacco Control ProgramWeb resources and Online/ onsite counselors
India Workplace Solution Products: Tobacco Cessation- Telephone Counseling
Quitline
Allows an individual quit at his convenience and with confidentiality
Does not involve workplace collaterals and employee engagement
Countrywide reach Provides an Introductory plus 5 counseling
sessions and three evaluations; additional help A high quit rate of 49% at six months
Launched in India in December 08; Tuesday- Saturday; 12-10PM
India Workplace Solution Products: Tobacco Cessation Onsite Freshstart - four one-hour sessions of tobaccocessation counseling program are held during a two-weekperiod Features Designed for adult tobacco users Convenient for most people’s schedules, even in the
workplace Uses group interaction to support an individual quit Addresses variety of reasons why people use tobacco Goals- Creating readiness and environment to support
quitting tobaccoAdvantages Makes maximum use of the tobacco user’s time Helps participants to set-up the QUIT DATE earlier in
the program
Sets in climate for becoming tobacco-free
Conclusion
Quitting benefits: The best way to limit harm due to tobacco is to quit now. "Most of it is reversible, particularly if you can stop early on “1
Quitting is “doable” and it is “good economics”
Tobacco cessation can succeed if workplaces provide it “free” to the employees
1. Tom Glynn, American Cancer Society. Personal Communication, 2009
Thanks
Questions?
Reference- www.cancer.orgContact- [email protected];[email protected] +91-93516 24313
