1. Going Smoke-Free: the Cleveland Clinic example Bruce Rogen MD, MPH Chief Medical Officer Cleveland Clinic Employee Health Plan

2. Cleveland Clinic Background

3. Cleveland Clinic Commitment Cleveland Clinic is dedicated to the health, wellness and prevention of disease for our employees, our patients and the communities we serve.

4. Health and Disease Prevention Programming History 20052010 Smash the Ash SmokeFree Greater Cleveland Farmers Market Chief Wellness Officer Go! Foods

5. Cigarette Use Decline 2003-2007 Cuyahoga Ohio USA 30 25 15 % 20 20032004200720052006

6. Cleveland Clinic Bends the Cost Curve Increase efficiency through integrated healthcare delivery systemsIncrease efficiency through integrated healthcare delivery systems Reduce burden of disease by addressing tobacco and obesityReduce burden of disease by addressing tobacco and obesity

7. Key tenets Key leadership must support and have strategy for moving forward Key leadership must support and have strategy for moving forward Incentivize positive changes; build personal responsibility for health Incentivize positive changes; build personal responsibility for health Importance of building a culture of wellness Importance of building a culture of wellness

8. Importance of communication Media/Communications/Marketing teams must be ready to:Media/Communications/Marketing teams must be ready to: -Notify personnel of the change and how it effects them -Address the positive nature of the change -Develop a timetable for roll-out -Respond to media inquiries

9. 2005…All CC campuses declared non-smoking 2005…All CC campuses declared non-smoking 2007…Hiring of smokers discontinued 2007…Hiring of smokers discontinued All new hires undergo cotinine testing. Positive test results…offer rescinded; free treatment; reapply in 90 days. All new hires undergo cotinine testing. Positive test results…offer rescinded; free treatment; reapply in 90 days. 2008…Free smoking cessation program for Employee Health Plan members. 2008…Free smoking cessation program for Employee Health Plan members. Only 8-10% of our current workforce currently uses tobaccoOnly 8-10% of our current workforce currently uses tobacco Moving Toward Non-Smoking…

10. ResourcesResources For current employees:For current employees: -Tobacco cessation is covered by employee health plan -Also covered for dependents For the community:For the community: -Tobacco Treatment Center - -clevelandclinic.org/tobaccotreatment

11. Insurance providers:Insurance providers: Does your health plan cover behavioral therapy, such as reading material, web-based programs and individual or group counseling, or non-traditional approaches such as acupuncture or hypnosis for beneficiaries? Their dependents?Does your health plan cover behavioral therapy, such as reading material, web-based programs and individual or group counseling, or non-traditional approaches such as acupuncture or hypnosis for beneficiaries? Their dependents? Does your health plan cover tobacco treatment medication such as Chantix, Zyban and Nicotine Replacement Therapy (NRT) covered for beneficiaries? Their dependents?Does your health plan cover tobacco treatment medication such as Chantix, Zyban and Nicotine Replacement Therapy (NRT) covered for beneficiaries? Their dependents?