MHS Smoking Cessation Initiative
The MHS Smoking Cessation Initiative is a plan to encourage healthy lifestyle choices among service members and dependents. The initiative will also generate additional revenue for the MHS as well as improve Air Force (Tri-Service) productivity. Please see attached pdf file for detailed description.
4 comments
Wes Rainey • over 13 years ago
Attached file has program info.
Wes Rainey • over 13 years ago
MHS Smoking Cessation Initiative – Maj Robert W. Rainey, 88 DTS, DSN: 787-9275
Significant numbers of private sector employers are demanding workers who smoke shoulder a greater share of their health care costs via incurring a penalty or higher portion of their health insurance costs. Some public sectors have begun a $50 per month surcharge for each smoker on a health plan. The Air Force (DoD) should implement a similar policy to encourage the adoption of healthy choices among members and dependents.
The direct benefit to the Air Force (DoD) being costs savings in healthcare expenditures as well as untold mission productivity losses during frequent member “smoking breaks”. One study suggested smoking employees cost organizations 18% more than non-smokers in healthcare costs. The Air Force and her sister services all have robust smoking cessation programs which are underutilized and capable to support this initiative. Sample Implementation Plan: Active duty members and dependents are given a choice of 6 months to quit smoking or pay a per month fee (per smoker) say $50/month.
- Note: this is not discriminatory, but common actuarial practice based upon risk-increasing life style choices
- Retirees and retirees dependents would be grandfathered and exempt from the program but offered a suitable reduction in annual healthcare premium if a non-smoker or to quit smoking on a per covered life basis.
- MTFs would identify individuals in EMRs who reported smoking and proactively schedule interventions.
- To encourage honest reporting of tobacco use among individuals, members or dependents that opt to smoke but do not reliably report use would be subject to billing for their entire annual healthcare premium.
- There are potential pitfalls with characterizing what is and is not a smoker. A derived definition of smoking would be the use of a smoking tobacco product (cigarette, cigar, pipe, etc) > 3 times per week. This would allow exceptions for occasional and irregular social use which has not been proven to contribute to significant health issues.
"Innovativeness"
- This would be an innovative means of influencing members and dependents to adopt healthy lifestyles Cost Effectiveness
- Additional revenue for MHS , Est 65,928 AF Smokers x $500/yr smoking surcharge = $ 32,964,000 o Est 20,000 AF dependent smokers x $500/yr smoking surcharge = $10,000,000
- A maximum of $42,964,000 in additional AF MHS revenue PER YEAR depending upon how many personnel and dependents opt to quit smoking.
- This initiative has the potential to generate significant health savings:
- Direct care costs due to smoking related illness
- Less provider time required to treat smoking related illness
- This initiative will generate significant savings and bolster productivity.
- About 20% of the US population smokes, numbers in the Air Force are similar. USAF end strength 329,640 so about 65,928 smokers. If each smoker takes just one 7 min smoking break per day (timed here at WPAFB) that translates to 1,999,816 lost man-hours of productivity, 1,041 FTEs (full time equivalents) and conservatively $7-8 million in labor costs (pay & benefits).
- Cost savings & mission impact are more difficult to tabulate but would be significant.
Ease of Implementation
- How complex will the implementation be? (See sample implementation plan above.
- Will several policy/law exceptions need to be made?
Some minor modification likely required. The retirees being exempt is directly designed to ease political resistance as they are the most vocal group and would receive a reduction in annual healthcare premium if a non-smoker. Will buy-in from the organization be required before implementation? Command and well as healthcare by-in should be possible to gain with low to moderate effort. Some resistance from smokers expected but these actions are common in the private sector. Frequent smoking breaks are a source of frustration with non-smokers which would most likely support this initiative. Scalability This would could be scaled (and most effective) if extended to all DoD. Tri-Service Tri-Service idea.
Helen Stucky Risdon • about 13 years ago
Very interesting and timely.
How are personnel supported in their efforts to quit? How effective are the programs that they have access to?
It seems that an incentive for seeking and making progress on cessation would be an important component.
Do you have the same data and support for alcohol and drug abuse?
Tobacco issues actually fall under that larger umbrella that has great costs to the MHS and society.
Wes Rainey • about 13 years ago
How are personnel supported in their efforts to quit? How effective are the programs that they have access to?
- Robust smoking cessation programs exist within all sister services. The programs, in my clinical experience, are effective if the patient genuinely desires to quit. By properly incentivizing, patients to quit using tobacco products, I expect success rates to climb.
It seems that an incentive for seeking and making progress on cessation would be an important component.
Do you have the same data and support for alcohol and drug abuse?
- These are more complex subjects and one involves potentially illegal substances. Alcohol abuse as well as drug abuse frequently requires medical intervention to alleviate withdrawal symptoms. It would also depend upon the particular agent one is abusing; it’s mechanism of biochemical action and potency /level of chemical dependency, etc. Tobacco cessation lends itself to easier monitoring in the work place as employees take “smoking breaks”, alcohol or drug abuse tend to be off-duty pursuits and hence are harder to track.
Tobacco issues actually fall under that larger umbrella that has great costs to the MHS and society.
True, I provided a very conservative estimate of potential savings in the text above.
Dr Rainey