BACKGROUND: Taft Hartley Funds provide group health care coverage for 10 million union workers as well as their dependents in industries such as construction and transportation. The adult smoking rate in these populations is estimated at approximately 40%, therefore, these funds include 9 million adult smokers. The absence of evidence demonstrating the effectiveness of smoking cessation programs has kept Taft Hartley Funds from investing in smoking cessation benefits. METHODS: A prototype for Taft Hartley Funds consistent with the Federal Clinical Guidelines for Smoking Cessation was designed and implemented in a pilot demonstration in the Carpenters Health and Security Trust of Western Washington. Participants chose a 1-call or more intensive 5-call smoking cessation counseling plan provided by the Group Health Cooperative's Free and Clear program. Medications were limited to the nicotine patch, nicotine gum, and Bupropion. Assessment of outcomes was performed by Free and Clear through a telephone survey 12 months following the enrollment date. RESULTS: Nine hundred thirty-five smokers participated in the program. This pilot evaluation covers 325 participants with at least 12 months since enrollment; 75% were male, the average age was 41.4 and 63% had smoked at least one pack per day for more than 20 years. Sixty-one percent selected 5-Call Counseling; 39% 1-Call. Seventy-five percent also used smoking cessation medications: gum, 4%; patch, 32%; Bupropion 21.5%; patch plus Bupropion, 15.7%. The point-prevalence-quit rates were: overall, 27.5%; 1-Call, 25.5%; and 5-Call, 28.9%. The cost of the program was $1025.28 per smoker who quit, or $11.78 per full-time equivalent employee covered by the Fund per year. The compounded savings in reduced lifetime tobacco-related medical costs for the participants who quit are estimated to be 15 times the cost of the program, yielding an annual return on investment of 27.6%. CONCLUSIONS: These results strongly suggest that smoking cessation programs can be effective even in such hard-to-reach populations as itinerant building trades workers, provided that the program is designed to their needs and environment. Based on these findings, health plans need to consider whether they are at risk of violating their fiduciary duties if they fail to offer smoking cessation benefits. Copyright 2002 Wiley-Liss, Inc.
BACKGROUND: Taft Hartley Funds provide group health care coverage for 10 million union workers as well as their dependents in industries such as construction and transportation. The adult smoking rate in these populations is estimated at approximately 40%, therefore, these funds include 9 million adult smokers. The absence of evidence demonstrating the effectiveness of smoking cessation programs has kept Taft Hartley Funds from investing in smoking cessation benefits. METHODS: A prototype for Taft Hartley Funds consistent with the Federal Clinical Guidelines for Smoking Cessation was designed and implemented in a pilot demonstration in the Carpenters Health and Security Trust of Western Washington. Participants chose a 1-call or more intensive 5-call smoking cessation counseling plan provided by the Group Health Cooperative's Free and Clear program. Medications were limited to the nicotine patch, nicotine gum, and Bupropion. Assessment of outcomes was performed by Free and Clear through a telephone survey 12 months following the enrollment date. RESULTS: Nine hundred thirty-five smokers participated in the program. This pilot evaluation covers 325 participants with at least 12 months since enrollment; 75% were male, the average age was 41.4 and 63% had smoked at least one pack per day for more than 20 years. Sixty-one percent selected 5-Call Counseling; 39% 1-Call. Seventy-five percent also used smoking cessation medications: gum, 4%; patch, 32%; Bupropion 21.5%; patch plus Bupropion, 15.7%. The point-prevalence-quit rates were: overall, 27.5%; 1-Call, 25.5%; and 5-Call, 28.9%. The cost of the program was $1025.28 per smoker who quit, or $11.78 per full-time equivalent employee covered by the Fund per year. The compounded savings in reduced lifetime tobacco-related medical costs for the participants who quit are estimated to be 15 times the cost of the program, yielding an annual return on investment of 27.6%. CONCLUSIONS: These results strongly suggest that smoking cessation programs can be effective even in such hard-to-reach populations as itinerant building trades workers, provided that the program is designed to their needs and environment. Based on these findings, health plans need to consider whether they are at risk of violating their fiduciary duties if they fail to offer smoking cessation benefits. Copyright 2002 Wiley-Liss, Inc.
Authors: Susan M Zbikowski; Lisa M Jack; Jennifer B McClure; Mona Deprey; Harold S Javitz; Timothy A McAfee; Sheryl L Catz; Julie Richards; Terry Bush; Gary E Swan Journal: Nicotine Tob Res Date: 2011-01-31 Impact factor: 4.244
Authors: Bruce A Christiansen; Kevin M Reeder; Erin G TerBeek; Michael C Fiore; Timothy B Baker Journal: Nicotine Tob Res Date: 2015-08 Impact factor: 4.244
Authors: Harold S Javitz; Susan M Zbikowski; Mona Deprey; Timothy A McAfee; Jennifer B McClure; Julie Richards; Sheryl L Catz; Lisa M Jack; Gary E Swan Journal: Transl Behav Med Date: 2011-03-01 Impact factor: 3.046
Authors: Gary E Swan; Jennifer B McClure; Lisa M Jack; Susan M Zbikowski; Harold S Javitz; Sheryl L Catz; Mona Deprey; Julie Richards; Timothy A McAfee Journal: Am J Prev Med Date: 2010-05 Impact factor: 5.043
Authors: Terry Bush; Michele D Levine; Laura A Beebe; Barbara Cerutti; Mona Deprey; Tim McAfee; Lindsay Boeckman; Susan Zbikowski Journal: Am J Health Promot Date: 2012 Nov-Dec