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After statewide ban, help smokers to quit

After statewide ban, help smokers to quit

Midlands Voices

Published in the Omaha World-Herald, July 15, 2008

By Dr. Lee Morrow
The writer, of Omaha, is an associate professor of medicine in the Pulmonary, Critical Care and Sleep Medicine Division at Creighton University.

Gov. Dave Heineman and the Nebraska Legislature deserve much praise for passing the Clean Indoor Air Act, the statewide ban on smoking in public places that takes effect on June 1, 2009.

This law and the appropriation of funds to help Nebraskans on medical assistance to quit smoking are investments in our state’s future in terms of improving health and lowering cost. As both a pulmonary physician and a taxpayer, I am grateful.

For Nebraska to maximize the benefits of this important law, employers need to go beyond simply making their workplaces smoke-free. They also need to incorporate smoking cessation and wellness programs into their cultures.

Furthermore, smoking cessation programs, public and private, should strictly adhere to the proven strategies detailed by the U.S. public health system and the federal Centers for Disease Control (CDC).

We know without a doubt that this comprehensive approach to smoking cessation — including the recognition that it may take a smoker multiple tries to quit — can save lives and money.

The CDC reports that tobacco use is the single most preventable cause of disease and death in the United States. Moreover, nearly 70 percent of U.S. adults who smoke cigarettes want to quit. By giving these motivated Nebraskans substantive support, the benefits will be tremendous.

We can’t afford to miss this opportunity for meaningful change. The CDC estimates that the U.S. economy loses $75 billion a year to the medical costs of tobacco use and an additional $92 billion to lost productivity through workers’ daily tobacco-related activities. Nebraskans alone pay $537 million in tobacco-related health costs each year.

To put it in more personal terms, the CDC found that a health care plan’s annual cost of covering treatment to help people quit smoking ranged from 89 cents to $4.92 per smoker. The annual cost of treating smoking-related illnesses ranged from $6 to $33 per smoker.

Furthermore, studies show that the state’s Medicaid program would save an estimated $13 million in five years if just one in four of current Nebraska smokers on Medicaid quit.

Ending widespread tobacco use would improve the health of Nebraskans, reduce personal and family suffering and greatly shrink this escalating state expense while boosting workplace productivity. All these benefits are available to Nebraskans in exchange for a short-term investment in success.

How can we achieve this? Based on extensive research and experience, the CDC has set standards for what it takes to help smokers quit: a combination of medical counseling, access to low-cost or cost-free, U.S. Food and Drug Administration- approved pharmaceutical aids, access to quit-line telephone support and the availability of supportive literature.

Also, the CDC recommends funding at least two attempts per year to quit. This is not only logical but also critical to maximizing the financial return of smoking cessation programs.

Any serious smoking cessation plan must take relapse into account. Research shows that many smokers require three or more attempts to quit. In fact, a recent U.S. surgeon general’s advisory to health care professionals states: “Tobacco dependence is a chronic disease that often requires repeated intervention and multiple attempts to quit. Effective treatments exist, however, that can significantly increase rates of long-term abstinence.”

Another highly credible source, WebMD, advises people who are trying to quit smoking: “If you relapse, don’t give up! Plan ahead and think about what you will do next time you get the urge to smoke.”

It’s not easy giving up an addiction to nicotine, but the good news is that with the right support, it can be done.

Where to begin? Public- and private-sector decision-makers should capitalize on the leadership of Gov. Heineman and the Legislature by incorporating effective smoking cessation programs into their benefits packages and programs.

The new statewide ban on smoking in public places takes effect in less than a year, and Omaha, Lincoln and other Nebraska communities already restrict smoking. It’s time that we put in place the tools Nebraskans need to quit smoking.

Smoking cessation has momentum, and our health care providers have the know-how to help smokers quit. Now, it’s up to our employer benefits managers and public health officials to develop the programs necessary to ensure that smokers and nonsmokers alike achieve maximum long-term benefits from our hard-won Clean Indoor Air Act.