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Research & Evidence
To reach late escalators in young adulthood when their smoking frequency is increasing, we recommend smokefree schools, smokefree college campuses, college-based smoking cessation programs, and bar-based smoking cessation and prevention interventions.
Beyond experimentation: Five trajectories of cigarette smoking in a longitudinal sample of youth
Ron Z. Goetzel, PhD, Raymond Fabius, MD, Dan Fabius, DO, Enid C. Roemer, PhD, Nicole Thornton, BA, Rebecca K. Kelly, PhD, RD, and Kenneth R. Pelletier, PhD, MD (hc). "The Stock Performance of C. Everett Koop Award Winners Compared With the Standard & Poor's 500 Index." American College of Occupational and Environmental Medicine, January 1, 2016.
Workplace health promotion programs are designed to improve the health and well-being of employees and their dependents. Companies that excel in their workplace wellness efforts can apply for and win recognition through numerous vehicles including earning the C. Everett Koop National Health Award (Koop Award). The Koop Award is conferred annually by The Health Project, a nonprofit organization founded in 1994 to promote employer achievements in improving population health cost-effectively. The hypothesis tested was that companies applying for and winning the Koop Award, thereby earning the distinction of having outstanding workplace health promotion (wellness) programs, would realize financial gains that extend beyond those simply offering traditional employee benefit programs.
"Cancer Facts and Figures 2016." American Cancer Society, January 2016.
Estimated numbers of new cancer cases for 2016, excluding basal cell and squamous cell skin cancers and in situ carcinomas except urinary bladder. Estimates are not available for Puerto Rico.
Note: State estimates are offered as a rough guide and should be interpreted with caution. State estimates may not add to US total due to rounding.
Towne, Samuel D. Jr., PhD, MPH, CPH, Kelsey E. Anderson, Matthew Lee Smith, Deborah Vollmer Dahlke, Debra Kellstedt, Ninfa Pena Purcell and Marcia G. Ory. "Changing organizational culture: using the CEO cancer Gold Standard policy initiatives to promote health and wellness at a school of public health." BMC Public Health, September 3, 2015.
Worksite wellness initiatives for health promotion and health education have demonstrated effectiveness in improving employee health and wellness.
Polinski, Jennifer M., ScD, MPH; Benjamin Howell, PhD, MPP; Troyen A. Brennan, MD, JD, MPH; William H. Shrank, MD, MSHS . "Impact of the CVS tobacco sales removal on smoking cessation: when CVS Health quit tobacco, many smokers quit, too." CVS Health, 2015.
The study, conducted by the CVS Health Research Institute, evaluated cigarette pack purchases at drug, food, big box, dollar, convenience and gas station retailers in the eight months after CVS Pharmacy stopped selling tobacco products.
Thornburg, Jonathan; Quentin Malloy, Seung-Hyun Cho, William Studabaker, and Youn Ok Lee. "Exhaled Electronic Cigarette Emissions: What’s Your Secondhand Exposure? ." RTI Press, Research Briefs, March 2015.
As e-cigarette use rapidly proliferates in the United States, research is needed to determine potential health risks posed by emissions from e-cigarettes. Currently, little scientific evidence on the toxicant exposures posed by e-cigarette use is available, particularly for a non-user’s secondhand exposures in public places.
Laurie P. Whitsel, PhD, Neal Benowitz, MD, Aruni Bhatnagar, PhD, FAHA, Chris Bullen, MBChB, PhD, Fred Goldstein, Lena Matthias-Gray, BS, Jessica Grossmeier, PhD, MPH, John Harris, MEd, Fikry Isaac, MD, MPH, Ron Loeppke, MD, MPH, Marc Manley, MD, MPH, Kare. "Guidance to Employers on Integrating E-Cigarettes/Electronic Nicotine Delivery Systems Into Tobacco Worksite Policy." Journal of Occupational and Environmental Medicine, March 2015.
In recent years, new products have entered the marketplace that complicate decisions about tobacco control policies and prevention in the workplace. These products, called electronic cigarettes (e-cigarettes) or electronic nicotine delivery systems, most often deliver nicotine as an aerosol for inhalation, without combustion of tobacco. This new mode of nicotine delivery raises several questions about the safety of the product for the user, the effects of secondhand exposure, how the public use of these products should be handled within tobacco-free and smoke-free air policies, and how their use affects tobacco cessation programs, wellness incentives, and other initiatives to prevent and control tobacco use. In this article, we provide a background on e-cigarettes and then outline key policy recommendations for employers on how the use of these new devices should be managed within worksite tobacco prevention programs and control policies
"E-cigarettes unhelpful in smoking cessation among cancer patients, study shows." Wiley, September 22, 2014.
In a new study of cancer patients who smoke, those using e-cigarettes (in addition to traditional cigarettes) were more nicotine dependent and equally or less likely to have quit smoking traditional cigarettes than non-users. Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the findings raise doubts about the potential benefits of e-cigarettes for helping cancer patients give up smoking.
Donatus U. Ekwueme, PhD, K. Robin Yabroff, PhD, Gery P. Guy, Jr., PhD, Matthew P. Banegas, PhD, Janet S. de Moor, PhD, Chunyu Li, PhD, MD, Xuesong Han, PhD, Zhiyuan Zheng, PhD, Anita Soni, PhD, Amy Davidoff, PhD, Ruth Rechis, PhD, Katherine S. Virgo, PhD. "Medical Costs and Productivity Losses of Cancer Survivors — United States, 2008–2011." CDC Morbidity and Mortality Weekly Report, June 13, 2014.
The number of persons in the United States with a history of cancer has increased from 3 million in 1971 to approximately 13.4 million in 2012, representing 4.6% of the population. Given the advances in early detection and treatment of cancer and the aging of the U.S. population, the number of cancer survivors is projected to increase by >30% during the next decade, to approximately 18 million. ...The results indicate that the economic burden of cancer survivorship is substantial among all survivors.
"IBI Chronic Disease Profile: Cancer." Integrated Benefits Institute, March 2014.
A growing recognition of the impact of workforce health on business performance has increased interest in workplace interventions and management strategies for chronic health conditions. In support of this broadened value proposition, IBI is drawing on a variety of information sources to publish a series of “disease profiles” for employers and their benefits partners. The profiles highlight the prevalence, full costs, co-morbidities and intervention approaches for key chronic health conditions. This month we profile cancer in the workforce.
"Best Practices for Comprehensive Tobacco Control Programs ." Centers for Disease Control and Prevention, 201.
Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Nearly one-half million Americans still die prematurely from tobacco use each year, and more than 16 million Americans suffer from a disease caused by smoking. Despite these risks, approximately 42.1 million U.S. adults currently smoke cigarettes. And the harmful effects of smoking do not end with the smoker. Secondhand smoke exposure causes serious disease and death, and even brief exposure can be harmful to health. Each year, primarily because of exposure to secondhand smoke, an estimated 7,330 nonsmoking Americans die of lung cancer and more than 33,900 die of heart disease. Coupled with this enormous health toll is the significant economic burden. Economic costs attributable to smoking and exposure to secondhand smoke now approach $300 billion annually.
"Coverage for Tobacco Use Cessation Treatments." Centers for Disease Control and Prevention, 2014.
This updated 2014 document provides an overview of the evidence base for tobacco cessation insurance coverage, best practices for designing cessation coverage, and the current status of cessation coverage.
"Do Workplace Wellness Programs Save Employers Money?." Rand Corporation, 2014.
Workplace wellness is a $6 billion dollar industry in the United States. Employers offer the programs to improve the health and well-being of their employees, increase their productivity, reduce their risk of costly chronic diseases, and improve control of chronic conditions. In 2012, half of all employers with at least 50 employees offered programs, and nearly half of employers without a program said they intend to introduce one.
U.S. Department of Health and Human Services. "The Health Consequences of Smoking—50 Years of Progress. A Report of the Surgeon General. ." U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.
This comprehensive report chronicles the devastating consequences of 50 years of tobacco use in the United States. It updates data on the numerous health effects resulting from smoking and exposure to secondhand smoke, and details public health trends, both favorable and unfavorable, in tobacco use. This report marks the steady progress achieved in reducing the prevalence of smoking and validates tobacco control strategies that have consistently proven to be effective. It also examines strategies with the potential to eradicate the death and disease caused by the tobacco epidemic at long last, and identifies specific measures that should be taken immediately to move smoking off its decades-old number one spot as the largest single cause of preventable death and disease for the citizens of the United States. Finally, the report documents that effective interventions are available and calls for their full implementation.
Lankford, Tina; Jason Lang, Brian Bowden, and William Baun. "Workplace Health: Engaging Business Leaders to Combat Obesity." Journal of Law, Medicine & Ethics, December 1, 2013.
Recognizing the adverse impact of obesity on employee productivity and health, many businesses have invested resources in worksite strategies to increase physical activity and improve the diets of their employees. Employers play a pivotal role in creating health-supportive environments for their employees as well as the community at large. Employers that contribute to a healthier workforce have the potential to reduce their out-of-pocket health care costs and improve productivity within their workforce. Further, through community engagement, employers can foster the improved health and stability of their future workforce
Fabius, Raymod, MD; R. Dixon Thayer, BA, Doris L. Konicki, MHS, Charles M. Yarborough, MD, Kent W. Peterson, MD; Fikry Isaac, MD; Ronald R. Loeppke, MD, MPH; Barry S. Eisenberg, MA; and Marianne Dreger, MA. "The Link Between Workforce Health and Safety and the Health of the Bottom Line: Tracking Market Performance of Companies That Nurture a “Culture of Health”." Journal of Occupational and Environmental Medicine, September 9, 2013.
A growing body of evidence supports the concept that focusing on the health and safety of a workforce is good business. Engaging in a comprehensive effort to promote wellness, reduce the health risks of a workforce, and mitigate the complications of chronic illness within these populations can produce remarkable effects on health care costs, productivity, and performance. The literature is replete with examples demonstrating that the health of employees impacts their performance and productivity. In addition, for the majority of the employers who pay for the cost of health care provided to their employees, there is a direct impact on the bottom line.