Snuffing out smoking

Coalition is helping employers encourage workers to quit

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Print this page by Marjolijn Bijlefeld

In December, a smoking ban takes effect in Virginia restaurants. Nonsmokers, no doubt, will welcome the change, but the law might add to the frustration of smokers who are struggling to quit.  “It takes a smoker an average of six times quitting in order to be successful,” says Melina Davis-Martin, president and CEO of the Richmond-based American Lung Association of the Atlantic Coast. “It takes tenacity to quit; it’s so addictive. People who want to quit but cannot can feel like pariahs in society.”

That’s one reason why Norfolk Southern Corp. in September dropped its co-pay requirements for any therapies that would help employees kick the nicotine habit. “Our goal here is to not have any obstacles” to giving up tobacco, says Robert Cramer, Norfolk Southern’s manager of human resources planning. “It’s almost surprising that we haven’t done this a lot earlier.”

There are some major financial reasons to help employees quit smoking. Studies show a smoker will cost an employer about $3,500 a year in lost productivity from absenteeism or poor health.  “While they’re there eight hours, they’re not really working eight hours,” he says. Cramer doesn’t know how many of his company’s 30,000 employees are smokers, but he thinks the percentage is higher than the Virginia average, nearly 21 percent of adults. The company spends about $375 million a year to cover health care costs for its employees and their dependents. “It’s pretty overwhelming,” he says. “That’s why a percentage here and a percentage there adds up.”

Norfolk Southern is trying to change its workplace culture by banning smoking on job sites and pushing employees to quit. “We’re looking to become smoke-free down the road,” he says. “Not that we can flip a switch, but we want to give people an opportunity to quit.”

As chairman of the Virginia Business Coalition on Health, Cramer hopes other businesses will be do the same. In fact, there’s a consortium of business, medical and health organizations working to promote smoking cessation programs. Davis-Martin says the American Lung Association is running a collaborative pilot program in Richmond and four other locations nationwide —Milwaukee; St. Louis; Harrisburg, Pa..; and Tucson, Ariz. The Richmond program “is farther, faster,” with a coalition of several hospitals, businesses, churches and sports teams (such as the Richmond Kickers) participating. For example, starting on Nov. 19, Bon Secours Richmond Health System facilities and the campuses of Henrico Doctors’ Hospital will become smoke-free. The lung association has developed an eight-week support program for quitters, available through on-site training sessions or the Web site


The Medical Society of Virginia Foundation has joined the effort to make sure that best practices in smoking cessation are available to health-care providers. “We need to make sure that doctors and staff are prepared when a patient says, ‘I’m ready to quit smoking,’ ” says Beth A. Bortz, the foundation’s executive director. “Some of that requires doing our homework, seeing what kind of smoking cessation benefits health plans provide and helping health-care providers know how to code for these services, where to find counseling services and what prescription medications are available.”

Meanwhile, the Virginia Business Coalition on Health is looking for ways to help businesses structure health benefits that encourage employees to quit smoking. “The No. 1 issue for the coalition is to improve community health, because we have a responsibility,” Cramer says. “We feel that by getting together with other major employers, we can begin to influence some of the decisions that we might not be able to influence on our own.”

Early next year, the coalition will offer its first curriculum on designing a smoking cessation benefit. Eileen Ciccotelli, the group’s vice president, says that while the program will target smoking, it can be applied to other health issues. These “value-based benefit design” programs will start in Richmond with the goal of bringing them online and expanding to other parts of the state.

Cramer says that companies must become more involved in the structure of these benefits. While employers pay for health coverage, insurers typically make most of the decisions on how the money is spent, he says. “The purchaser of health care is removed from the buying decisions, and that’s a pretty troublesome dynamic,” Cramer says. The compensation for primary care physicians is a key issue, he adds, because if they’re not paid enough by insurers they’ll drop out, and more-expensive specialists will have to step in. “We’ve got to straighten out the compensation for primary-care physicians,” he says. “We think the coalition can help move that along.”

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