OTC drugs hurt enrollment
Nicotine replacement therapy may help employees quit smoking, but since these products have been available over the counter, it has also been hurting the rate at which people sign up for smoking cessation classes, says Denise G. Jolicoeur, health educator for Humana in the metro Kansas City region.
"Initial enrollment rates were much higher," notes Jolicoeur, who introduced the American Institute For Preventive Medicine’s Smokeless program to Humana members in 1996. She says she attributes the dropoff in enrollment directly to the mid-1996 availability of nicotine patches without the need for a prescription.
She finds this particularly disturbing because her participants were having great success using both the behavior modification program and the nicotine replacement therapy.
"When I looked at the immediate end of treatment, we had a much higher quit rate with the replacement therapy 92% vs. 60%," she says. "When we get to 12 months, we’ve seen a 29% quit rate with people who have used nicotine replacement, and 21% without."
Program participants are taught about the patches during an introductory session. They are told about the pros and cons of the patches and are given the option to use them. Historically, about 54% of the participants chose the patch, reports Jolicoeur.
The reason enrollment rates have dropped since the patches became available over the counter, she says, can be found in our popular culture. "Just look at our commercials," she observes. "We believe that if we just take a pill or a drug, it will take care of everything. We may see the same thing happening with the new weight control drugs."
How can this "quick fix" mentality be overcome? "If I could have done it over again, I would have incentivized coming to class," says Jolicoeur. "For the employee, it’s the difference between $5 or $10 every two weeks [the co-pay] and $40 or $50."
To help combat the temptation to use the patch alone, Humana is trying to develop a "one-shot" class designed to help people explore all their reasons for quitting before they decide to sign up. "We hope this will help them focus on looking at a class and joining when they are ready," says Jolicoeur. "It may help improve quit rates as well as encourage commitment."
[Editor’s Note: For more information, contact: Denise G. Jolicoeur, Humana, Inc., 8550 Marshall Drive, Lenexa, KS 66214. Telephone: (913) 495-2036. Fax: (913) 438-4435.]
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