Employers ponder tough tactics to halt smoking Symposium presents tough tactics to halt habit that costs state billions in medical care, lost work hours

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Howard Weyers tried the "carrot" approach by giving his employees incentives and encouragement to quit smoking. But when that didn't work, he resorted to the stick. A big stick.

Weyers, owner of a health care benefits administrator in Lansing, Mich., gave his 200 employees an ultimatum in 2004: Quit smoking in 15 months or lose your job. He refused to hire smokers. Ultimately, he extended his smoking ban to employees' spouses and monitored compliance through mandatory random blood testing.

Weyers' method, while effective, wouldn't fly in California because the state has laws that prohibit employers from making hiring or firing decisions based on employee participation in a legal activity. But participants in a smoking cessation forum hosted Monday by the Commonwealth Club of California found the idea nonetheless intriguing.

"We're talking about ending an epidemic. This is a global pandemic," said Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, likening Weyers' approach to controlling an outbreak of disease.

About 45 million Americans, 4 million of whom live in California, smoke cigarettes despite more than three decades of public efforts to encourage people to quit.

California, on both the state and local levels, has been at the forefront of anti-smoking efforts with laws to ban smoking in public places. A law went into effect in January that prohibits drivers from smoking when children are in the car. Still, smoking costs the state an estimated $8.6 billion in direct medical costs and $7.3 billion in lost productivity a year, according to the California division of the American Cancer Society.

In addition to lost work hours, employers have a vested interest in getting their workforce to kick the habit, given that they pay a large portion of health care costs and are the main source of health insurance for more than half the population.

At Monday's event, officials from the California Public Employees' Retirement System, the third-largest purchaser of health care in the country, said they asked the three health insurers that provide coverage for the fund's 1.2 million state and local employees to increase member participation in smoking cessation programs by 20 percent next year.

"We don't want to know if there's a cost associated with this. It's in (the health plans') best interest and ours to do this," said CalPERS spokesman Brad Pacheco.

Safeway Inc. announced that its Pleasanton headquarters will become smoke- and tobacco-free as of July 1, with the ban extending to all regional offices in Canada and the United States as of Sept. 1. Safeway already requires nonunion employees who do not participate in smoking-cessation efforts to pay more for their health premiums and is in discussions to extend the policy to union workers.

Safeway prefers to influence its smokers through incentives rather than penalties, said Larree Renda, an executive vice president with the grocery chain. "Our focus right now has been one of being supportive and trying to help people quit smoking," she said.

Renda took considerable heat from audience members because she works for a company that espouses healthy lifestyles but sells tobacco products. Renda said Safeway has no plans to quit selling tobacco because it does not dictate what legal products its customers should buy, and ceasing cigarette sales would put the company at a competitive disadvantage.

Meanwhile, the San Francisco Board of Supervisors is considering a law that would ban the sale of cigarettes and tobacco products in the city's drugstores.

Panel members had several suggestions for employers, such as providing benefits that cover smoking cessation programs, medications and counseling. A major hurdle to such efforts is the fact that employees change jobs frequently and typically have to change health benefits with each job.

California employers do not have to offer smoking cessation programs to employees. Gov. Arnold Schwarzenegger vetoed a 2005 bill by former state Sen. Debra Ortiz, D-Sacramento, that would have required health insurers that cover prescriptions to include coverage for programs to help people quit smoking. The governor, a cigar smoker himself, supports increasing cigarette taxes.

On the federal level, Congress is considering a bill that would give the U.S. Food and Drug Administration greater authority to regulate tobacco products. The bill, which is endorsed by Philip Morris USA, is controversial in part because it bans all flavored cigarettes except menthol, which are particularly popular among African Americans.