TRENDS IN TOBACCO And What Employers Can Do to Support Cessation Katy Tombaugh, Certified Tobacco Treatment Specialist Founder & CEO, Wellness Collective LEARNING OBJECTIVES Understand the types of tobacco products trending in today s market & associated risks Describe the benefits of helping employees to quit tobacco use (and how this impacts workplace culture) Understand how pharmacotherapy doubles quit rates and other cessation best practices Identify ways to support employees and their spouses in quitting tobacco UNDERSTAND TOBACCO TODAY 1
FAST FACTS ON TOBACCO Tobacco use is the single most preventable cause of death and disease in the United States. Each year, approximately 443,000 Americans die from tobacco-related illnesses. For every person who dies from tobacco use, 20 more people suffer with at least 1 serious tobacco-related illness. Tobacco use costs the U.S. $193 billion annually in direct medical expenses and lost productivity. Source: Healthy People 2020; Office of Disease Prevention & Health Promotion THE RISKS Tobacco use causes: Cancer Heart disease Lung diseases (including emphysema, bronchitis, and chronic airway obstruction) Premature birth, low birth weight, stillbirth, and infant death THE RISKS CONTINUED There is no risk-free level of exposure to secondhand smoke. Secondhand smoke causes heart disease and lung cancer in adults and a number of health problems in infants and children, including: Severe asthma attacks Respiratory infections Ear infections Sudden infant death syndrome (SIDS) 2
TOBACCO TRENDS & ASSOCIATED RISKS Type Cigarettes Fast Facts Contain more than 7,000 chemicals, at least 69 of which are known to cause cancer. Smoking is the number one factor for lung cancer. E-Cigarettes/Vaping Unregulated by the US Food and Drug Administration; not an FDA-approved cessation intervention. Early studies have shown that e-cigarettes contain nicotine (even when advertised nicotine-free) along with other harmful chemicals and carcinogens. Smokeless Tobacco There are many unknowns about the long-term health effects. Level of nicotine is higher than cigarettes (one can delivers an amount equal to 60 cigarettes). Contains 28 carcinogens. Cigars Also unregulated. A single large cigar contains as much tobacco as an entire pack of cigarettes. Pipe Hookah Similar risks and health effects as other types of tobacco; linked to a variety of cancers. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. Similar risks to cigarette smoking in terms of exposure to carcinogens and cancer risks. THE BIG BENEFITS OF HELPING EMPLOYEES TO QUIT TOBACCO BENEFITS OF QUITTING Immediate physiological improvements; HEALTH COST-savings Quality of LIFE Freedom from ADDICTION Frees up TIME on a daily basis An American Productivity Audit found that tobacco use was a leading cause of worker lost production time more than alcohol abuse or family emergencies. (CDC) 3
YOUR WORKPLACE CULTURE How is your current tobacco policy and programming impacting your workplace culture? HOW TO HELP PEOPLE QUIT TOBACCO 4
ABOUT QUITTING 70% of adult smokers would like to quit 40-50% will try 2-4% actually quit (National current quit rate) Note: Those who quit do so with the help of environmental supportand educational efforts. Smoke-free policies lead to lower cigarette consumption per employee And may increase cessation among employees Source: ATTUD, CDC QUITTING CAN BE COMPLEX According to ATTUD and the CDC, smoking is now associated with: Fewer personal resources (lower income, lower education, lower access) Depression/Anxiety Disorders Severe Psychopathology Substance Abuse Childhood Disorders UNDERSTAND OBSTACLES Physical dependence Fears around quitting Other health conditions Environmental cues Accompanying habits Misconceptions around the benefits of quitting 5
UNDERSTAND WITHDRAWAL Insomnia Restlessness Anxiety, irritability, frustration, anger Difficulty concentrating Sadness; depressed mood Increased appetite Decreased heart rate BEST PRACTICES IN TOBACCO CESSATION EVIDENCE-BASED TREATMENTS Tobacco should be treated as a Chronic Illness. The CDC also recommends offering a menu of treatment intensities that maximize reach and effectiveness. Self-Help Brief Treatment from Healthcare Providers Telephone Treatment Group & Individual Treatment 6
INTERVENTIONS Types of Interventions: Spontaneous quit Physician advice Onsite individual counseling Onsite group counseling Telephone counseling Best Practices: Intensive interventions (>10 minutes) are more effective. Combine counseling with medication (pharmacotherapy). It s ideal to meet more than four times. Contact time of 31-90 minutes produces abstinence rates that are significantly higher. PHARMACOTHERAPY FDA-Approved medications include: OTC Nicotine Replacement Therapy (NRT) Formulations Gum Lozenge Transdermal Preparations (patch) Rx Nicotine Replacement Therapy Nasal Spray Oral Inhaler Rx Therapies Other Buproprion SR (Zyban) Varenicline (Chantix ) QUIT SUPPORT - CONSIDERATIONS Professional Support: Physicians, Certified Tobacco Treatment Specialists Extent of Addiction: Assessment Change Planning: Coaching or Counseling Onsite or Telephonic Support: Short Term & Long Term Solutions Pharmacotherapy: Access & Education 7
CRAFT YOUR PLAN Essential Questions Do you offer a range of treatment options (by phone, face-to-face, intensive)? Are FDA-approved medications covered? Are you providing treatment options regardless of readiness to quit? What percentage of tobacco-users are enrolling in services? Are you offering low-cost/no-cost pharmacotherapy? Are you creating a culture of wellness? What else needs to happen? COMMUNICATION CONSIDERATIONS Employers should: Reassure tobacco users that the company is not trying to stigmatize them but is concerned about their health Demonstrate the company's commitment to supporting employees who use tobacco products in their efforts to quit. Indicate desire for improving employee health. Educate on the ability to reduce tobacco-related healthcare costs. RESOURCES FOR EMPLOYEES & EMPLOYERS 8
NATIONAL RESOURCES American Cancer Society 800-227-2345 cancer.org Americans for Nonsmokers Rights no-smoke.org American Lung Association 1-800-LUNGUSA quitterinyou.org ffsonline.org American Medical Association 1-800-QUIT-NOW ceasetobacco.org Centers for Disease Control and Prevention cdc.gov/tobacco Kill the Can (smokeless tobacco) killthecan.org Legacy becomeanex.org National Institutes of Health smokefree.gov National Cancer Institute 877-44U-QUIT (877-4487848) cancer.gov CONTINUED Nicotine Anonymous nicotine-anonymous.org QuitNet quitnet.com Tobacco Technical Assistance Consortium ttac.org United State Environmental Protection Agency epa.gov/smokefree WORKPLACE-SPECIFIC RESOURCES CDC: Implementing a Tobacco-Free Campus Initiative in Your Workplace Tool Kit http://www.cdc.gov/nccdphp/dnpao/hwi/toolkits/tobacco/index.htm The American Cancer Society: Tobacco-Free Workplace Tool Kithttp://www.cancer.org/downloads/gahc/tobaccofree_workplacetoolkit_2009.p df The American Lung Association: Guide to Safe & Healthy Workplaces http://www.lung.org/our-initiatives/healthy-air/indoor/at-work/guide-to-safe-andhealthy-workplaces/ 9
QUESTIONS? Contact: Katy Tombaugh katy@wellnesscollective.com 614-832-5662 10