Cost of giving up – Should companies start paying employees extra financial rewards to quit smoking, asks BRIAN O’CONNELL

A STUDY of 878 General Electric employees who smoked an average of one pack of cigarettes a day, was carried out in 2005 and 2006, by a team from the University of Pennsylvania and part-funded by the US government’s Centre for Disease Control and Prevention (CDC).

The participants were divided into two groups and members of one group were given up to $750 for kicking the habit, with saliva and urine samples taken to confirm they had stopped. The study found that 14.7 per cent of the group offered financial incentives had stopped smoking within the first year of the study.

Only 5 per cent of the other group managed to stay smoke free, tripling the rate of success for the group offered financial incentives.

The latest report on the group found that 9.4 per cent of the paid group were still not smoking several years on, compared with 3.6 per cent of those who got no money.

Leading the University of Pennsylvania research team was Dr Kevin Volpp, an associate professor at the University of Pennsylvania School of Medicine. “In the last few years people have become a lot more interested in approaches like this. In the US, 70 per cent of smokers say they want to quit, and about 2 per cent or 3 per cent actually succeed.

“There is a big disconnect in public health terms between what people would like to do, and what is happening on the ground, with over 440,000 Americans dying from smoking-related illnesses every year.”

Volpp and his team arrived at the $750 financial incentive by comparing two health insurance policies a company would have to pay for a 40-year-old smoker and non-smoker respectively. By insuring the non-smoker, the company would save $750.

“The benefit to companies in having programmes like this,” says Volpp, “is one of the reasons the private sector is taking notice. Under the current system, employees who smoke generally have lower productivity and higher absenteeism. So there is strong economic self-interest in having employees quit.”

But how do you ensure that employees who sign up to the study actually smoke in the first place, and stop when they say they stop?

“That’s obviously a little tricky,” says Volpp. “GE has a very strong corporate integrity policy, so if employees are found to be lying to the company, they are likely to lose their jobs.

“They are actually planning to roll out the smoking programme to all their workers next January, and feel that the existence of that corporate integrity document will limit the likelihood of falsehood.”

Volpp points to recent studies that estimate each employee who smokes costs employers an additional $3,400-$3,600 a year, between sick days and loss of productivity.

Volpp argues that if part of that cost is put into measures to get employees to stop, then the company makes costs savings.

“When you think about it, in the US $2.2 trillion is spent by the government on healthcare every year, with 97 per cent of that outlay on acute illness. What we are saying is, are there ways to use this money more effectively?

“The current lung cancer treatments are not very effective, so in using some of that money upfront to motivate persons to quit, is a good societal response to the problem.”

So, could the initiative work in Ireland? Despite taking the lead in inaugurating the workplace smoking ban, smoking numbers in Ireland have crept up in recent years, putting us above the UK and US in percentage terms (29 per cent of the adult population in Ireland smokes, compared with 20 per cent in the US and 24 per cent in the UK).

So while wider society may regard smoking in public places as totally unacceptable, smokers, it seems, are carrying on regardless.

Dr Angie Brown, consultant cardiologist and chairwoman of the charity ASH, is not sure the programme is sustainable on a larger scale.

“Clearly it worked very well in that small group in a company situation, where the company would have a good handle on the number of smokers. Still, it’s only a 15 per cent success rate.

“I would have concerns about the programme in a larger population where it would be fraught with difficulties. I’d prefer to see the money being spent on support for people to give up smoking, such as smokers’ quit lines, nicotine-replacement treatments and on making it as cheap as possible to provide supports to help people stop smoking.”

Brown points out that the number one incentive for any smoker stopping should be “to prolong life and make you feel better”.

Norma Cronin, health promotion manager with the Irish Cancer Society, is a little more supportive of the study. “We do know that incentives work, but first smokers need to really want to quit. Some Irish companies have had incentives like competitions run over a three-month period with monetary prizes or holidays at the end of it. Overall in Ireland, the reality is that we really are not seeing a decrease in smoking levels.

“I believe we need comprehensive tobacco control, mass media campaigning and significant price increases. Also, there is not enough support for smokers to quit, and there should be much greater investment in tobacco-control initiatives. I think that incentives could work and they don’t need to be huge. A year is also a very good time to judge the merits of any programme, and employers all see the benefits of having employees quit. So, why not?”

But what do smokers themselves think? Make-up

artist Susan Ahern has a 20- a-day habit stretching back over a decade. “I’ve never really put any effort into trying to quit,” she says, “I know the incentive to quit should be to improve your health, but money talks.

“It doesn’t have to be money though, it could be a contribution towards gym membership or something like that. If someone did offer me 800 quid, especially in today’s climate, I’d have to think hard about it!”

Musician Brian Carey, who has been a regular smoker for 20 years, says he wouldn’t be overly tempted by a financial offer to quit. “I smoke very little – roughly five cigarettes a day – and have never tried to give them up. They’d want to pay me a lot more than €700 or €800 to stop!

“I would be one of the few who can smoke a small amount, maybe five cigarettes a day. I have never had a health scare because of it and consider myself relatively fit. For instance, I’m just in the door from a long cycle. Admittedly though, the first thing I did when I came in was light a cigarette!”

(source: http://www.irishtimes.com/newspaper/health/2009/0224/1224241701344.html)

Richard Reid is the founder of Pinnacle Proactive, Specialising in the Employee Assistance ProgramStress ManagementStaff Retention & Absenteeism. Take a Proactive Approach to Growing Your Organisation & its People. For more info visit http://www.pinnacleproactive.com

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