1. Reaching the Unreachable: Helping the Working Underserved Quit Tobacco Melissa Watford, EdM Cindy Laton FirstHealth of the Carolinas Tobacco Use Prevention and Cessation Program

2. Background ä FirstHealth of the Carolinas - a private, non-governmental, not-for-profit health care network serving 15 counties in the mid- Carolinas.

3. Background W.K. Kellogg Community Voices/American Legacy Foundation Initiative FirstHealth of the Carolinas’ mission is to provide disadvantaged communities with tobacco use prevention education and opportunities for tobacco cessation services for those ready to quit.

4. Background ä The targeted counties for this project are poor with many people in low wage manufacturing jobs, often having no insurance coverage. With North Carolina as the largest producer of tobacco in the United States, tobacco use has economic, political and social as well as health ramifications.

5. Program Overview (cont.) Occupational Sites Through initial surveys conducted at occupational sites: – 23% of employees report occasional/regular cigarette use ” 72% indicate willingness to attend a program, but only 5% have ever attended a program ” 19% uninsured: males 57%, females 43% 4 Occupational Site Results: ” Provided cessation services at 12 work sites ” 107 employees have completed the program with 78 tobacco free upon completion ” 25.7% 6-month quit rate “ 79 patients financially assisted with oral medication/nicotine replacement therapy

6. Why Provide Cessation Services at an Occupational Site? Accessibility Accessibility Support systems Support systems Improved health for the employee Improved health for the employee Increased employee production Increased employee production Benefit to the employee from the employer Benefit to the employee from the employer Convenience for employees who have more than one job or family commitments Convenience for employees who have more than one job or family commitments Sources: Centers for Disease Control and Prevention: Office on Smoking and Health, USDHHS, Wellness Council of America, American Cancer Society, Making your workplace smokefree: A decision maker’s guide 1996 Center for Health Promotion and Publications. The Dollar (and sense) Benefits of Having a Smoke-Free Workplace. Lansing, Michigan: Michigan Tobacco Control Program: 2000.

7. Getting Started t Referral from Health Plan t Occupational Environmental Scan t Surveying of Employees t Informational sessions t Employee sign-up t Begin sessions

8. Occupational Site Champions

9. PolicyPolicy PINEWILD COUNTRY CLUB OF PINEHURST

10. Support Systems

11. Support Systems (continued)

12. Employee Recognition

13. Accessibility

14. Accessibility (continued)

15. Improved Employee Health and Production

16. Challenges Classes are on worker time, so less buy-in from worker Most work sites are not smoke-free Manager involvement in cessation classes Culture Tobacco climate in North Carolina

17. Successes and Sustainability Quit rates Policy change Occupational site buy-in Increased request for services Linkage with the health plan More work place and community sites becoming smoke-free

18. Resources www.workingsmokefree.com ()NC's web-page devoted to helping businesses develop tobacco-free policies) www.endsmoking.org (Employers’ Smoking Cessation Guide developed by Professional Assisted Cessation Therapy – PACT)

19. Contact Information Melissa Watford (910) 215-4439 mwatford@firsthealth.orgwatford@firsthealth.org Cindy Laton (910) 215-4435 claton@firsthealth.org