OBJECTIVE

To quantify the return on investment of a digital tobacco cessation program from an employer perspective by analyzing healthcare cost savings and productivity gains in a real-world workplace setting.

METHODS

This quasi-experimental study analyzed medical claims data from a self-insured US manufacturing company, comparing healthcare costs between program enrollees ( = 153) and matched non-enrollees ( = 3,943) over a 12-month post-enrollment period. Exact and propensity score matching were used to address selection bias, followed by difference-in-differences analysis to control for temporal trends. The study population included employees and spouses continuously enrolled in the company health plan from November 2019 through December 2023. Administrative claims data captured all healthcare services, while productivity benefits were estimated through simulation modeling using published parameters and conservative assumptions for absenteeism reduction and presenteeism improvements. The analysis adopted an employer perspective with a 1-year time horizon, incorporating both direct medical cost savings and indirect productivity gains.

RESULTS

Program enrollees demonstrated $950 lower annual healthcare costs compared to matched non-enrollees within the first year of enrollment (95% CI = -$2,022-$122;  = 0.083 using difference-in-differences analysis). Productivity gains contributed an additional $960 per enrollee (95% CI = $446-$1,614), resulting from reduced absenteeism and improved workplace performance. Combined healthcare and productivity savings totaled $1,910 per participant (95% CI = $694-$3,158). At a program cost of $200 per participant, this yielded a return on investment of $9.55 for every dollar invested (95% CI = $3.47-$15.79). Sensitivity analyses confirmed robust positive returns across varying assumptions about abstinence rates and productivity parameters.

CONCLUSIONS

Using rigorous econometric methods to minimize confounding bias, this analysis demonstrates substantial employer cost savings from implementing a digital tobacco cessation program. The nearly 10-fold return on investment, driven by both healthcare savings and productivity improvements, provides compelling economic evidence for employers evaluating digital health solutions in workplace wellness programs.