STOP-SMOKING PROGRAMS FUNDED BY EMPLOYERS FOUND EFFECTIVE

DALLAS - The number of workers who quit smoking increases when employers
fully cover the cost of cessation programs offered by insurance companies,
according to a new study.

The results challenge the common belief among employers that smokers should
be motivated enough to pay for at least part of their counseling, nicotine
patches and other aids.

"If employers want to reduce the prevalence of smoking, then their best bet
would be to get full coverage of smoking cessation," said Louis Grothaus of
the Group Health Cooperative of Puget Sound, a consumer-owned HMO that
covers about 450,000 people.

In a study published in yesterday's issue of the New England Journal of
Medicine, Grothaus and his colleagues compared four different levels of
coverage for stop-smoking programs in 1993 and 1994.

In some cases, smoking cessation was a fully covered benefit. With other
plans, patients paid half the cost. Although the employees who had a
co-payment were indeed more likely to quit over the term of the study, four
times as many people attempted to kick the habit when the program was a
covered benefit.

About 3 percent of the smokers who had full coverage in the HMO were able
to quit in a given year. With the standard coverage, only 1 percent of the
HMO's smokers stopped. The study, conducted in Washington state, was
sponsored by a grant from the Tobacco Policy Research and Evaluation
Program of the Robert Wood Johnson Foundation.

Some local employers said they would be willing to pay higher premiums if
they were convinced that full coverage for smoking cessation programs paid
off.

But companies generally appear more interested in improving short-term
medical outcomes than changing employee behavior.

"Most companies give (smoking cessation) lip service, if that, because the
payoff is really long term," said George Crowling, regional health-care
manager for GTE in Irving, Texas. "In general, companies say, `Geez,
suppose I support this program, in 20 years he may not get cancer, but in
six months he may be out of here.' That's always the conundrum with these
sorts of programs."

Plano, Texas-based Electronic Data Systems sets a $300 lifetime limit on
smoking-cessation programs for employees and their spouses, said Jay Salem,
director of employee administration. If workers spend less than that to
kick the habit, the cost is fully covered, he said.

Still, few people avail themselves of the benefit, he said. "We have a very
low population of people who smoke in EDS."

Smoking is a leading preventable cause of heart disease, cancer and lung
problems. Public-health experts say that employees who don't smoke cost
less not only in health-care costs but also in missed time from work and
lost productivity.

The federal Centers for Disease Control and Prevention estimates that about
47 million adult Americans are smokers and that the habit cost the nation
$100 billion in smoking-related illnesses in 1996.

Several health insurers said they try to keep their program costs low so
smokers will participate.

Checked-by: Pat Dolan