Prepared for 2002 National Conference on Tobacco or Health

1. Prepared for 2002 National Conference on Tobacco or Health Wednesday - November 20, 2002 - 10:30 AM

2. The American Cancer Society: The nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer through research, education, advocacy and service.

3. The American Cancer Society2015 Goals: • Reduce Cancer Mortality by 50% • Reduce Cancer Incidence by 25% • Measurably Improve the Quality of Life for Cancer Patients and Families

4. The American Cancer SocietyObjectives / Tobacco: • Reduce to 12% the proportion of adults • (18 and older) who use tobacco products by 2015 • Decrease the prevalence of tobacco use in adults by 8% by 2005

5. The American Cancer SocietyObjectives / Tobacco: • What does this mean for New Jersey? • Reach a projected 490,419 adults by 2005 • Reach a projected 122,605 adults each year

6. The New Jersey Worksite Tobacco Program

7. Worksite Program Goals • Increase barriers and provide disincentives to workplace smoking behavior by affecting meaningful, comprehensive worksite policy change. • Decrease barriers and provide incentives for cessation by increasing the availability, utilization and effectiveness of tobacco dependence treatment resources in worksites throughout New Jersey.

8. Program Objectives: • Affect meaningful systems change in large worksites • Expose large corporate populations to the message of tobacco control • Enhance utilization of state-sponsored resources • Expand restrictions on smoking in the workplace • Increase demand for, and access to, cessation services and products

9. The New Jersey Worksite Tobacco Program • Cooperative effort between ACS and DHSS, Comprehensive Tobacco Control Program, with funding by the Master Settlement Agreement • Systems-based interventions designed to assist corporate worksites to take ownership of the tobacco issue and promote New Jersey Quitline, Quitnet, &Quitcenters

10. Partner with worksites by: • Create & strengthen policy • Promote company ownership of tobacco issue • Promote NJ Quitnet, NJ Quitline and NJ Quitcenters in support of policy change • Incentives package to promote company buy-in & employee involvement

11. Worksite Incentives to Promote Policy Change: • $500 ACS in-kind on-site “Tobacco Control Resource Center” • $1000 for program promotion/participant incentives (with ACS guidance) • Opportunity to take part in Billboard Initiative

12. Incentive Development: “Health Promotion & Smokefree Recreation” • Health club membership • Subsidize NRT’s • Smokefree Restaurants • Movies • Spa • Lunch/refreshments • Special event

13. Billboard Initiative: • Billboards throughout New Jersey • “Smokefree Facilities. Smokefree Employees.” • 4 corporations exhibiting “excellence in worksite tobacco control” in 2002 – 2003 • Celebrate partnership, promote corporate ownership of issue, recruit new partners

14. Worksite Process: • Step 1: Recruitment • Step 2: Implementation / Support • Step 3: Evaluation

15. Recruitment: • Recruit through ACS existing protocol / collaborate with corporate relations • Promote Quitline, Quitnet, Quitcenters • “Proactive step in promoting the health and wellness of employee population” • Administrative buy in / internal mechanism to support program • “Worksite Partner Agreement”

16. Worksite Partner Agreement: • Provide/maintain on-site coordinator • Training space/materials/promotion • Consideration of policy change, benefits analysis, company sponsored incentives • Content disclaimer • Utilize funds to promote program and reward participants via health promotion/smokefree recreation

17. Implementation / Support: • Hands on assistance planning / implementing “Clearing the Air” policy change and cessation services • Available for telephone/e-mail support and troubleshooting, as needed • Informal & formal (2-month & 6-month) follow up • Quarterly site visits, at worksite discretion

18. Evaluation: • Six month evaluation via ACS Tracking Tool: • Number of partnerships established • Number of cessation programs run through referral resources • Number of participants/successes • Number of worksite tobacco control policies created/strengthened

19. The New Jersey Worksite Tobacco Control Programhas 4 components • Tobacco Education • Clearing the Air • Nicotine Dependence Treatment • Advocacy & Outreach

20. I. Tobacco Education • Tobacco Facts • Phases of Tobacco Use • Initiation • Addiction • Stopping • Treatment • Maintenance

21. II. Clearing the Air Inform corporate decision-makers about policies proven to reduce smoking. Provide technical assistance related to health insurance, smoke-free policies and employee incentives to quit smoking.

22. Overview of Clearing the Air • Costs of Tobacco Use • Workplace Policies • Smokefree Workplace • Cessation Coverage • Four Steps to a New Policy

23. Healthcare Costs Lost Productivity Total Costs $716 $840 $1556 Each year smoking costs U.S. employers an average of $1556 in additional health care costs and lost productivity per smoking employee (Towers Perrin, 1999)

24. WORKPLACE POLICIESBenefits of a Smokefree Workplace for the Employer • Reduced health care costs • Decreased absenteeism • Reduced smoking and relapse • Increased productivity • Decreased maintenance costs

25. WORKPLACE POLICIES Benefits of a SmokefreeWorkplace for the Employer • Increased life of office equipment, carpets and furniture • Lower health, life, disability, and facility insurance costs • Decreased risk of fires • Decreased risk of liability • A more attractive workplace

26. WORKPLACE POLICIES Benefits of a SmokefreeWorkplace for the Employee • Helps create a safe, healthful workplace • Decreased resentment among employees • Smokers appreciate a clear company policy about smoking at work • Managers are relieved by a clearly defined policy

27. Factors to Consider When Creating a Policy • Greatest benefits • Easy implementation • Laws and ordinances • Customer and community expectations

28. Smokefree Campus Policy “_______________ and its affiliates desire to promote the wellness of our employees by incorporating a total ‘smokefree’ campus, effective _______________.” Date

29. Smokefree Campus Policy Purpose: “The health hazards of smoking have been well documented as they impact both the smoker and the non-smoker who is exposed to second hand smoke. It is our intent to provide all employees with an environment conducive to good health and a productive atmosphere.”

30. Smokefree Campus Policy “Applicable to all team players, contractors, guests, and visitors while on the property or in any of our New Jersey based locations.”

31. Smokefree Campus Policy “All employees, contractors and visitors are prohibited from smoking cigarettes, pipes, cigars, and/or chewing tobacco on site at ___________. On site is defined as inside all New Jersey facilities, as well as on the grounds and parking lots, and inside company owned and personal vehicles on company property.”

32. Smokefree Campus Policy “Employee non-compliance with the policy will result in disciplinary action, up to and including termination from employment. All cases of non-compliance with this policy will be reviewed with Human Resources and action will be taken in accordance with established company policies and procedures.”

33. Workplace Policies • Cessation Coverage and Incentives • Fully Cover Cessation Services and Products • Provide Incentives to Stop Smoking

34. Reduce Barriers and Offer Incentives to Encourage Participation • Hold cessation classes during work hours • Incentives also demonstrate support for smokers • Bonus vacation days • Reduced employee contributions for benefits • Refund payment upon completing program • Monetary awards

35. 1 ASSESS 2 DECIDE 3 COMMUNICATE 4 ANNOUNCE Four Steps to a New Policy

36. III. Nicotine Dependence Treatment • State-specific resources for cessation • On-site resource provision and referral • Worksite cessation and support.

37. Nicotine Dependence Treatment • More intensive treatment and follow-up leads to better results • Tobacco dependence should be viewed as a chronic disease that will require long-term intervention

38. NJ QUITNET nj.quitnet.com NJ QUITLINE 1-866-NJ-STOPS NJ QUITCENTERS Contact NJ QUITNET or QUITLINE

39. NEW JERSEY ADULT TOBACCO SURVEY • For those who have never tried to quit: • 39% would use toll- free telephone counseling service • 48% with internet access would use internet help

40. NJ QUITLINE • Officially opened 10/26/2000 • A professional telephone counseling service • Managed by Mayo Foundation • New Jersey area codes call 1-866-NJ- STOPS • Counselors available Monday-Friday from 8 am until 8 pm (except holidays), and Saturday from 11 am until 5 pm. • Counseling available in twenty six languages

41. NJ QUITLINEFEATURES • Telephone counseling appropriate to the client’s stage of change. • Primary treatment -initial assessment and counseling followed by a minimum of three additional calls. • Scheduling of calls accommodates the client’s need. • Mails supportive written materials

42. NJ QUITLINE6 Month Follow Up Program To Date • 37% Cohort Quit and Reduced Use • 45% Respondents Quit and Reduced Use

43. Household Income • <$15,000 21% • >$15,000-<$25,000 15% • >$25,000-<$35,000 16% • >$35,000-<$50,000 16% • >$50,000-<$75,000 16% • >$75,000-<$100,000 8% • >$100,000-<$125,000 5% • >$125,000 3%

44. Age • 17 yrs and under < 1% • 18-24 yrs. 8% • 25-34 yrs. 19% • 35-44 yrs. 30% • 45-54 yrs. 23% • 55-64 yrs. 14% • 65-74 yrs. 5% • 75-84 + yrs. < 1%

45. Ethnicity • White Caucasian 66% • Black/African American 21% • Hispanic 11% • Other Asian >1% • Asian Indian >1% • Portuguese >1% • American Indian >1% • Korean >1% • Vietnamese >1% • Chinese >1% • Filipino >1%

46. NJ QUITNET • Officially opened 10/26/00 • An online service with URL at www.nj.quitnet.com • Accessible 24 hours a day 7 days a week • Developed by Join Together and Boston University

47. NJ QUITNET FEATURES • Resources for Everyone • Quit Tip of the Day • Quitting Calendar • Directory of Local Programs • Quitting Guides • Print Materials • Pharmaceutical Guide • ¿Habla español? • Personalized Services • Peer to Peer Support • Expert Q&A • Consult an Expert • Quitting Tools • Quit Date Wizard • Quit Tips and Anniversary E-mails

48. NJ QUITNET Visitors YTD ( 10/25/00-8/31/02) Once 45,667 More than Once 20,921 Total Visitors 66,588 Registrants 9,750

49. NEW JERSEYQUITCENTERS • 15 Centers • Population Density Based • Training by UMDNJ • Provide 35 hours of Counseling per Week • Provide subsidized NRT

50. Quitcenter Services • Information regarding Tobacco Dependence • Individual,comprehensive assessment by a trained tobacco dependence specialist • Measurement of expired carbon monoxide at each appointment • Individual or group counseling • Pharmacotherapy (NRT, buproprion and combinations) • One and six month post quit date follow up