Here is the latest post from EBV guest blogger Linda K. Ridell, this time on why a tobacco-cessation program might not be the best use of your company's wellness dollars. Enjoy, and as always, share your thoughts in the comments. —K.B.

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Smoking is a well-known health hazard that kills 400,000 people every year across all genders, income levels and ethnic backgrounds. However, when it comes to quitting smoking, it turns out that not everyone benefits equally from quitting.   
Studies show that people who have lower social economic status (SES) have a higher risk of developing lung cancer, compared to people of higher status. Specifically, people who have low education (high-school degree or less) have a 61% higher incidence of lung cancer.  People of lower status also had higher rates of chronic obstructive pulmonary disease and emphysema.
Strangely, the differences cannot be explained by the amount that people with lower SES smoke. True, a greater percentage of lower SES people use tobacco (In 2009, 31% of adults below the federal poverty level smoked, compared to 19% of those at or above the poverty level). Yet, such research compares people who smoked the same amount. In fact, for COPD and emphysema, lower SES individuals had a higher risk for illness even if they smoked less than their well-to-do fellow smokers. 
Thus, like overall wellness programs http://ebn.benefitnews.com/blog/ebviews/linda-riddell-disease-management-high-risk-groups-science-2721998-1.html, a tobacco-cessation program delivers more health impact for a group that has lower social-economic status.  
The “everyone-needs-to-quit-smoking” approach leads to misusing scarce wellness resources. Wellness programs should look very carefully at their population and discern what will bring the greatest health.  The answer is not always obvious.  

Smoking is a well-known health hazard that kills 400,000 people every year across all genders, income levels and ethnic backgrounds. However, when it comes to quitting smoking, it turns out that not everyone benefits equally from quitting.   

Studies show that people who have lower social economic status (SES) have a higher risk of developing lung cancer, compared to people of higher status. Specifically, people who have low education (high-school degree or less) have a 61% higher incidence of lung cancer.  People of lower status also had higher rates of chronic obstructive pulmonary disease and emphysema.

Strangely, the differences cannot be explained by the amount that people with lower SES smoke. True, a greater percentage of lower SES people use tobacco (In 2009, 31% of adults below the federal poverty level smoked, compared to 19% of those at or above the poverty level). Yet, such research compares people who smoked the same amount. In fact, for COPD and emphysema, lower SES individuals had a higher risk for illness even if they smoked less than their well-to-do fellow smokers. 

Thus, like overall wellness programs, a tobacco-cessation program delivers more health impact for a group that has lower social-economic status.  

The “everyone-needs-to-quit-smoking” approach leads to misusing scarce wellness resources. Wellness programs should look very carefully at their population and discern what will bring the greatest health.  The answer is not always obvious.  

Guest blogger Linda K. Riddell is a principal at Health Economy, LLC, where she works with clients on gaining practical tools to comply with health care reform, and to maximize the new opportunities that health reform offers. She can be contacted at LRiddell@HealthEconomy.net.

 

 

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