Moses Olivia, Rea Brenda, Medina Ernie, Estevez Dennys, Gaio Josileide, Hubbard Mark, Morton Kelly, Singh Pramil N
Risk Management, Loma Linda University, Loma Linda, United States.
School of Public Health, Loma Linda University, Loma Linda, United States.
Tob Prev Cessat. 2020 Apr 7;6:23. doi: 10.18332/tpc/118237. eCollection 2020.
Systematic analyses of workplace smoking cessation programs indicate that efficacy can be enhanced by using incentives. There is variation in the type of incentives used and their effect on participation and efficacy. The aim of our study was to examine whether lowering employee health plan costs (employee contributions, co-pays) encourage employee smokers to participate in workplace smoking cessation.
We conducted a 2014-2015 prospective cohort study of 415 employee smokers of Loma Linda University Health (LLUH). The employees were offered participation in a workplace smoking cessation program (LLUH BREATHE Initiative) with the incentive of enrollment in an employer-provided health plan that had a 50% lower employee monthly contribution and co-payment relative to the employer-provided health plan for non-participants. Participation rates and variables associated with participation were analyzed.
In the LLUH BREATHE cohort, we found a very high rate of participation (72.7%; 95% CI: 69-77%) in workplace smoking cessation that was encouraged by a lower out-of-pocket health plan cost for the participating employee and/or spouse. Participation did, however, vary by gender and spouse, whereby female employee households with a qualifying smoker were more than two times more likely (employee: OR=2.89, 95% CI: 1.59-5.24; or spouse: OR=2.71, 95% CI: 1.47-5.00) to participate in smoking cessation than male employee households. The point prevalence, at four months, of abstinence from smoking among the participants was 48% (95% CI: 42-54%).
Our findings indicate that a workplace smoking cessation program that uses a novel reward-based incentive of lower out-of-pocket health plan costs results in a participation rate that is much higher than US norms.
对职场戒烟项目的系统分析表明，使用激励措施可提高其效果。所使用的激励措施类型及其对参与度和效果的影响存在差异。我们研究的目的是检验降低员工健康计划成本（员工缴费、共付额）是否会鼓励员工吸烟者参与职场戒烟。
我们于2014年至2015年对洛马林达大学健康中心（LLUH）的415名员工吸烟者进行了一项前瞻性队列研究。这些员工被提供参与一项职场戒烟项目（LLUH呼吸倡议）的机会，激励措施是加入雇主提供的健康计划，相对于未参与者的雇主提供的健康计划，该计划的员工月缴费和共付额降低50%。分析了参与率及与参与相关的变量。
在LLUH呼吸队列中，我们发现职场戒烟的参与率非常高（72.7%；95%置信区间：69 - 77%），这是由参与项目的员工和/或其配偶较低的自付健康计划成本所推动的。然而，参与情况因性别和配偶而有所不同，有符合条件吸烟者的女性员工家庭参与戒烟的可能性是男性员工家庭的两倍多（员工：比值比=2.89，95%置信区间：1.59 - 5.24；或配偶：比值比=2.71，95%置信区间：1.47 - 5.00）。参与者在四个月时的戒烟点患病率为48%（95%置信区间：42 - 54%）。
我们的研究结果表明，一项采用降低自付健康计划成本这种新型基于奖励的激励措施的职场戒烟项目，其参与率远高于美国的标准。
