Integrating smoking control policies into employee benefits: a survey of large California corporations

Public health policy promotes the use of risk-rating health insurance and payment for smoking cessation as economic incentives to encourage smoking cessation. This study was undertaken to learn more about the adoption of these policies in large corporations. A random sample survey of 280 private California corporations with more than 500 employees was undertaken to document the prevalence of policies integrating smoking control into employee benefit designs. Only 8.6% of large corporations had ever considered risk-rating health insurance premiums using smoking status and only 2.15% had implemented a risk-rating policy. Nearly 20% of the companies offered health insurance plans that covered smoking cessation services. Subsidization or payment for smoking cessation outside health insurance was provided by over 37% of the companies surveyed, and 87% had adopted formal work-site smoking policies. Benefit policies that provide financial support to smokers to participate in smoking cessation services are much more prevalent and are viewed more positively by the benefits managers in large corporations than are policies to risk-rate health insurance premiums on the basis of smoking.