Cash speaks louder than traditional smoking cessation aids

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Employers looking to help workers quit smoking have found financial rewards are much more effective than providing alternative cessation methods like e-cigarettes and nicotine patches.

But a new study says it’s not nearly as effective as straight-up paying people to quit smoking.

The New England Journal of Medicine recently published a study finding that smoking cessation aids such as patches, gum or e-cigarettes offered for free in corporate wellness programs are not particularly effective in getting employees to quit. Financial incentives, however, fared somewhat better.

“We know smoking remains a leading cause of preventable death,” says Christine Brophy, director of research and development for Vitality Group and a study author. Workforce smokers are costing employers $3,000 to $6,000 more on average than nonsmokers, she notes. “It’s a hot topic for employers and those trying to help employers manage costs.”

Researchers invited employees from 54 companies and their spouses to enroll in the trial if they were current smokers. The companies represented a range of industries, including education, manufacturing and construction, finance and insurance and biotechnology. All of them used the same suite of wellness programs.

In addition to receiving the usual wellness program care, workers were randomly assigned to one of these following groups:

· Free cessation aids (nicotine-replacement therapy or pharmacotherapy, with e-cigarettes if standard therapies failed)
· Free e-cigarettes without a requirement that standard therapies had been tried
· Free cessation aids plus $600 in rewards for sustained abstinence
· Free cessation aids plus $600 in redeemable funds, deposited in a separate account for each participant, with money removed from the account if cessation milestones were not met.

The team found that of the 1,191 smokers who opted into the study, 12.7% successfully quit cigarettes when the researchers threatened to take money away from them. E-cigarettes, however, were far less motivating: only 4.8% of the 1,191 participants successfully kicked the habit by vaping.

“The bottom line is it’s expensive to have an employee who smokes and it’s expensive to get them to quit. It takes a smart incentive structure to get employees to take up a healthier lifestyle,” Brophy says of the trial.

A number of large companies offer the promise of healthcare premium reductions for smokers who quit, but lower premiums isn’t as tangible a thing as an account with $600.

“We did find with some of the participants they were much more inquisitive in “their money” and how we wanted them to feel,” Brophy notes. “We do think that that’s a very interesting framing position to take with incentives.”

And not every employer can just dole out money in their wellness programs to help smokers quit. “The communication strategy around incentives is important in helping to find that motivation regardless, of the dollar amount,” she said.

Talking up wellness

And communication is essential in establishing and promoting wellness program offerings. For Baylor College of Medicine based in Houston, it offers a few different smoking cessation programs.

“You have to make sure it’s important to the people doing it,” said Jesse Gavin, team leader for Baylor College’s BeWell Wellness program. “Make sure you have a clear vision of what they want and expect. For example, we really want to make a culture of health.”

At Baylor, there is a $50 surcharge on premiums to entice smokers to stop. When workers participate in the cessation programs offered — an encompassing and extensive course including one-on-one coaching and nicotine replacement therapy — the surcharge will fall off.

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He adds that it’s important to keep access and communication open. Baylor has a little more than 10,000 employees, Gavin says, and many work at other institutions or affiliate hospitals.

“Still have people that come to us and didn’t know the program existed,” he adds. “We utilize about 30 different avenues of communication.”

Wellness is a challenge, according to Gavin. It gets a bad rap and employees don’t want to hear from their doctors and their employers that they need to lose weight or give up tobacco.

Let employees know you’re there to be a partner and not force things down their throat, he adds. “Sometimes it takes a catastrophic event — like a heart attack — before they wake up. Let them know ‘we’re here when you want to make that switch.’”

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Smoking cessation Wellness Wellness programs Wellness disincentives Health and wellness Healthcare costs Healthcare benefits