The enormous cost of insuring tobacco users, due to health conditions caused by smoking, has employers and health plans offering quit-smoking incentives to encourage users to quit.
The Mercer National Survey of Employer-Sponsored Health Plans found that 22% of large employers (500 or more employees) use tobacco surcharges. Among employers with 20,000 or more employees, this increases to 41%. Many employers offer to remove the tobacco surcharge when participants show they achieved specified steps in a tobacco cessation program.
Quit-smoking incentives can be a great way to encourage an already motivated person to make the decision to quit. Research shows that incentives can also generate higher rates of smoking cessation compared to those who only receive information about quitting.
But they can have a downside, too. Quit-smoking incentives can unintentionally foster resentment in those who don’t really want to quit but feel forced to do so.
As an EX Coach with over a decade of experience in helping people make lifestyle changes, I’ve heard the pushback. The sequence of statements I typically hear from those who are unhappy about “having to chat” with me includes:
- I’m only doing this to get the discount on my insurance. (To relate it to baseball, this statement is like hearing the umpire yell “Strike 1!” with 2 outs in the bottom of the 9th.)
- I don’t even want to quit; my company is making me. (“Strike 2!”)
- I think this whole thing is pointless but I have to do it for the incentive at work. (“Strike 3!”)
When I hear these statements, does it mean game over for me as a coach? Absolutely not. For me, it means we head into extra innings.
Where quit-smoking incentives end and we start
As an EX Coach, my job is to really listen to what members say. Many times, simply echoing “yes, you don’t want to be here doing this” can go a long way.
My approach is not to brush over this reality, as people want to feel heard and are more likely to open up if they sense it is safe to be honest. I tell people I’m not the smoking police and that it’s ok to feel this way. If I can get a “lol” out of them with that comment in our chat, I know we’re going in the right direction.
Exploring why members enjoy smoking and if they notice any negative aspects in their life from tobacco use is a helpful place to start if they are not ready to discuss a quit attempt.
I use open-ended questions to keep the conversation moving forward with purpose. (There’s no quicker way to totally shut someone down than asking a series of closed-ended questions to a person who is disengaged with the program before it starts.)
Through this process of meeting people where they are at, and helping them glean insight about their smoking and how quitting might improve their quality of life, I find I can plant a seed about quitting that might not have been there before. When this happens, I see the dynamics shift and members start to share these statements instead:
- Maybe my kids will stop nagging me about quitting if I actually do this now.
- I guess I could use the extra money. I hate giving it to the tobacco companies anyway.
- It would be nice to play with my grandkids without feeling like I can’t breathe.
These might seem like baby steps, but through our chat we now have a starting point when they didn’t even want to participate initially. As a coach, that’s a home run in my book—when I can help someone see the benefits of quitting and that quitting is possible, even if it takes several tries to meet the end goal.
Incentives might feel like a “stick” to a smoker who isn’t yet committed to the idea of quitting. But the simple truth is they are effective in getting someone to step up to the plate and reach out, which can be a critical first move in a new way forward.