What’s ahead for tobacco cessation programs?

As 2019 draws to a close, tobacco use is still a problem in your workplace. This year the Center for Disease Control and Prevention (CDC) Office on Smoking and Health declared 2019 its Year of Cessation, but our work is not done. We recently learned from our webinar that 60% of attendees, most of whom were employers, have employees who use e-cigarettes or vape during the work day. Plus the CDC has cited more than 2,000 illnesses related to vaping. These statistics speak to how the tobacco landscape is evolving. Cessation programs must also evolve to address these dynamics.

Tobacco use burns your business
In 2019 employee tobacco use will cost U.S. employers $300 billion in medical expenses, lost productivity, worker’s compensation and smoking breaks[1]. That’s 3,905 per tobacco using employee. However, despite the decline in combustible cigarette smoking, the use of Electronic Nicotine Delivery Systems (ENDs), or e-cigarettes, has drastically increased recently and continues to attract more new users. In fact, the Surgeon General declared vaping an epidemic among youth. The dramatic increase of e-cigarette use in young adults means a whole new generation – the workforce of tomorrow – is becoming addicted to nicotine.

The tobacco landscape of the future
Research and headlines are telling us that vaping is not completely safe. Vaping may contain harmful ingredients including volatile organic compounds, ultrafine particles that can be inhaled deep into the lungs, and flavorings made from chemicals linked to serious lung disease. It’s not surprising that in recent months vaping may have led to serious lung disease and deaths across the country.

What’s more, we cannot forget that more than 480,000 Americans die per year from combustible/commercial tobacco use – that’s 1,300 deaths every day – many of those are among vulnerable populations. In fact, tobacco use is the leading cause of preventable disease, disability, and death in the United States[2].

Optum is committed to the cause of helping people become nicotine-free and closely following the CDC’s findings on the vaping epidemic. In addition, we remain at the forefront of tobacco cessation research to best inform future treatment protocols and help.

Digital cessation support meets users wherever they are
Even as the tobacco landscape changes, one constant remains: Quitting tobacco is hard. A one-size-fits-all approach to quitting doesn’t work.

For the average tobacco user, it takes anywhere from five to seven attempts to quit before reaching success. And close to 50% of all tobacco users attempt to quit each year. We know that most individuals do not utilize evidence-based interventions – programs that could double or triple their chances of success[3].

More than ever, we see evidence that there is more than one way to quit. Innovative, personalized multi-modal cessation programs are critical to quit success. Today, consumers demand digital tools to meet their individual needs. This means cessation programs should offer features to help users quit on the go, including digital tools such as text enrollment and support, mobile apps, self-paced online learning, and specialized content.

Research also shows that cessation programs that use multiple modalities may be more effective and drive better engagement:

  • Those who engage with telephonic, web and text support have a 57% quit rate[4]
  • Participants with a combination of engagement modalities are 4.4 times more likely to quit[4]

Specialized programs help meet unique needs
Over the past year, Optum research shows that when quit support is personalized to specific populations, outcomes increase. Research also shows that specific populations, including people living with behavioral health issues, veterans, LGBTQ and those in drug abuse recovery, continue to use tobacco at rates that are above average.

The development of specialized protocols for those with depression, anxiety, or other behavioral health diagnoses allows for specific support targeted to meet unique needs. These actionable supports include removing enrollment barriers, offering specific coaching, increasing nicotine replacement therapy and working with the participant’s health care provider to reinforce the necessary support needed to achieve success.

The result? Our behavioral health pilot program had 30-37% quit rates, higher than the average 22% quit rate among those with behavioral health condition[5].

The future of cessation programs
As we look to 2020 and beyond, Optum will continue research to inform future treatment protocols and identify new ways to support businesses help their employees quit tobacco. Regardless of the industry, healthier employees mean potentially lower benefit costs and higher productivity.

For more than 30 years, Optum has helped people live healthier lives with our industry-leading evidence-based tobacco cessation program. We also believe it is critical to raise awareness about the continuing problem of tobacco use, the changing tobacco landscape and the financial and health costs tobacco use places on families and businesses. For more information, visit optum.com. 

Meet the Author


Mary Kokstis
Senior Director of Product Capabilities, Coaching at Optum

Mary Kokstis has been involved in quitline services since 2000, having served in roles including call center operations, implementation, RFP sales and client services. Her 18 years of experience is grounded in the meaningful and powerful impact telephonic behavior change coaching can have on an individual. Ms. Kokstis has a 360 degree view of the quitline landscape and a unique understanding of the markets that purchase tobacco cessation services, reasons why they purchase and their specific needs. She is a senior member of Optum’s telephonic and digital wellness coaching product team, which includes our tobacco cessation offering. She has had the opportunity to oversee the satisfaction of our 700+ commercial employer and health plan clients. She continues to listen to both the consumer and market needs with passion, holistic perspective and innovation. Mary has her Bachelor of Science degree in Community Health and Fitness & Exercise Science from Western Washington University.


[1]Berman M, Crane R, Seiber E, et al.: Estimating the cost of a smoking employee. Tob. Control. 2014; 23(5):428-433.
[4]Quit For Life enrollment data as of May 2019.
[5]Kelly M Carpenter, Chelsea M Nash, Robert A Vargas-Belcher, Katrina A Vickerman, Vincent Haufle, Feasibility and Early Outcomes of a Tailored Quitline Protocol for Smokers With Mental Health Conditions, Nicotine & Tobacco Research, Volume 21, Issue 5, May 2019, Pages 584–591, https://doi.org/10.1093/ntr/ntz023

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