Enhancing employer coverage of smoking cessation treatment: A randomized trial of the Partners in Helping You Quit (PiHQ) program

• Published in: Preventive medicine Vol. 140; p. 106216
• Main Authors: Rigotti, Nancy A., Kelley, Jennifer H.K., Regan, Susan, Inman, Elizabeth, Kalkhoran, Sara, Flaster, Amy, Chaguturu, Sreekanth K.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2020
• Subjects: Quitline; Randomized controlled trial; Smoking cessation; Telephone counseling; Workplace; Smoking cessation; Quitline; Workplace; Randomized controlled trial; Telephone counseling
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2020.106216

The workplace is a key channel for delivering tobacco cessation treatment to a population. Employers can provide workplace-based programs and/or financial incentives such as health insurance benefits that cover the cost of treatment accessed outside the workplace. Little is known about the effect of combining these strategies. We tested the benefit of adding a workplace cessation program, Partners in Helping You Quit (PiHQ), to comprehensive health insurance coverage of smoking cessation medications by Partners HealthCare, a large Boston-based healthcare delivery system. PiHQ offers biweekly telephone-based behavioral support, additional automated calls, and medication care coordination for 3 months then monthly telephone monitoring for 9 months. In a pragmatic randomized trial, employees who smoked were informed about the insurance benefit, then randomly assigned (2:1) to PiHQ or to active referral to a free 3-month phone-based community program, Massachusetts Quitline (QL). Outcomes were assessed at 3, 6, and 12 months. During 2015–2018, 106 smokers (n = 73 PiHQ, n = 33 QL) enrolled (64% female; 75% white, 21% black; mean age 46 years, mean cigarettes/day = 13). More PiHQ than QL participants made a quit attempt by 3 months (82 vs. 61%, p < .02) and achieved the primary outcome, verified past 7-day cigarette abstinence at 6 months (31 vs. 12%, odds ratio 3.34, 95% CI, 1.05–10.60). Among participants using behavioral support, PiHQ participants completed more scheduled calls and rated counseling helpfulness higher than did QL participants. These results suggest that employers can enhance the impact of providing comprehensive health insurance coverage of smoking cessation medication by adding a phone-based worksite cessation program. •Employers can promote smoking cessation with worksite programs or health insurance benefits.•We tested the benefit of offering a worksite program to employees with health insurance benefits.•The program increased quit attempts and smoking cessation rates at 6-month follow-up.