An alarming study by the Robert Wood Johnson Foundation and Virginia Commonwealth University reported that to live a long and healthy life, one should eat right, exercise, quit smoking — and move out of Mississippi.
The statement, as stinging as it sounds, is not to insult Mississippi but to point out that our residents have the lowest life expectancy of all 50 states.
It is well documented that a complex web of risk factors can affect one’s health. However, two risk factors in particular impact the health of those who live and work here. Mississippi has the highest adult obesity rate and the sixth highest rate of smoking.
As a practicing dentist for the past 30 years, I have witnessed the damage that smoking and spit tobacco use does to the mouth and lips. Tobacco use causes gum disease and tooth loss as well as cancer of the lips, tongue, floor of the mouth and throat.
In fact, over 80 percent of oral cancer deaths are attributed to tobacco use. Using spit tobacco increases the risk for oral cancer four to six times, and smokers are seven times more likely to develop periodontal disease.
While smoking is most often associated with lung cancer and other lung diseases, it is also the leading cause of, among others, nasal, sinus, tracheal and laryngeal cancers.
Burdens of smoking
In addition to the human toll that tobacco use takes on our families and loved ones, there is also the financial burden.
A Centers for Disease Control and Prevention report estimates that smoking costs our nation as much as $170 billion annually in health care costs, and 8.7 percent of overall health care spending can be attributed to cigarette smoking. Nearly 60 percent of that cost is paid for by taxpayers in the form of public programs such as Medicaid and Medicare.
Tobacco use also affects the employer. A study by an Ohio State professor found that an employee who smokes costs a self-insured employer $5,816 annually in absenteeism and lost productivity from taking smoke breaks, time spent thinking about smoking, traveling to and from smoking areas and health care costs.
And since an estimated 24 percent of adult Mississippians smoke, just imagine the financial burden on companies, both large and small, in our state.
What can we do?
The most logical and helpful approach is offering tobacco treatment programs to help users quit. Research has shown that more than two-thirds of all smokers want to stop, but only about three out of 100 succeed in quitting on their own.
One option that many states have successfully implemented includes insurance companies enhancing their coverage by waiving or minimizing the copay or deductible costs for treatment via counseling and medications for their tobacco-using employees.
A second option would be for private companies to help fund tobacco treatment programs for their employees.
The average smoking cessation cost per employee is under $500, which represents a strong return on investment when compared to the $5,816 that smoker costs an employer. This is a win-win proposition, since the employer will gain a healthier, more productive employee who is likely to miss less work, feels better, saves money and has more to offer while on the job.
Mississippi has several programs funded by the Mississippi State Department of Health that provide assistance to employers who are interested in implementing a program at their worksite. Individual, group and telephone counseling are effective and widely available for many different groups of smokers.
Smoking cessation is the single most cost-effective health insurance benefit for adults — better than preventive treatments for high cholesterol and high blood pressure.
Studies have shown that counseling and medications work best and, there are seven medications approved by the FDA to aid in quitting tobacco use. Nicotine patches, gum and lozenges are available over the counter, and a nicotine nasal spray and inhaler are available by prescription. Buproprion SR (Zyban) and varenicline tartrate (Chantix) are non-nicotine pills.
It is important to note that all of these medications have been shown to improve quit rates but are most effective when used in combination with counseling.
There are many reasons and statistics to compel employers to implement tobacco treatment programs, but the best reason is the simplest of all: It’s the right thing to do.
Karen M. Crews, professor emeritus of the University of Mississippi Medical Center School of Dentistry, is a practicing dentist at Beach View Family Dental Clinic in Gulfport.