The Well-Being Journal

E-Cigarettes Aren't for Quitters

Jennifer Rudloff

e cigaretteElectronic cigarettes have been heavily marketed the past 5 years, first as a miracle quitting aid and now as a substitute for conventional smoking. As tobacco treatment specialists, we're in favor of anything that diminishes a smoker's odds of suffering tobacco-related illness or death, but should e-cigarettes be considered legitimate quit-tools?

Being a science-and-evidence-based quit-smoking program, QuitNet can only recommend treatments that are FDA approved, clinically researched, and proven effective. QuitNet does not include the use of e-cigarettes in its roster of suggested tobacco treatments, for the following reasons:

  • E-cigarettes are not proven quit-tools: There is little research on the role of e-cigarettes in helping smokers become tobacco-free. A handful of limited and/or manufacturer-funded studies indicate a potential harm reduction benefit to users, but none have demonstrated a causal relationship between use and subsequent tobacco/nicotine abstinence.
  • E-cigarettes are officially designated as tobacco products: U.S. federal courts ruled that electronic cigarettes cannot be considered quit-smoking aids by the FDA, but must be regulated as tobacco products. After this ruling, the largest distributors of e-cigarettes admitted their products were intended as smoking substitutes, not quit-aids:

“Understand that this is a cigarette. We are acting as a cigarette company. We have all the applicable warnings on all our packaging that actually backs that up...We do not represent the product as healthy or safe.” - Ray Story, VP of Smoking Everywhere

“We can now market our product the way we always should have been able to...This is plain and simple [sic] an alternative to smoking for committed, longtime smokers." -- Matt Salmon, CEO of Sottera Inc

  • E-cigarettes reinforce most aspects of conventional smoking: Unlike existing quit-smoking aids (including nicotine inhalers), e-cigarettes deliver nicotine directly to the lungs--making users potentially as dose-responsive to them as they are to conventional cigarettes. Unlike NRT, e-cigarettes allow users to continue engaging in most of the potentially harmful mental and behavioral patterns associated with smoking. Unlike NRT, e-cigarettes present multiple physical, visual and behavioral relapse triggers at every use.
  • E-cigarettes are not the same as Nicotine Replacement Therapy (NRT): NRT has been proven and designated a therapeutic quit-aid, not a tobacco product. The primary action of e-cigarettes -- inhaling nicotine directly into the lungs -- runs counter to the primary action of NRT. It’s the slow, measured uptake of small, standardized levels of nicotine that makes NRT so effective, as well as the breaking down of established smoking behaviors and routines (acquisition, preparation, lighting up, hand-to-mouth, etc) inherent in their use. Numerous inspections of e-cigarette products also demonstrate wide variations between claimed and actual nicotine doses (even from 'puff-to-puff'), making self-monitoring and/or 'stepping down/weaning off' unreliable and less effective.
  • E-cigarettes are not proven safe: The short or long-term effect on the lungs of glycolized e-cigarette steam (containing nicotine and some identified toxins) has not been extensively studied nor deemed safe. Manufacturing standards have not been set, nor is any oversight entity charged with creating or enforcing them. Dosages vary widely, and some cartridges have been found to contain enough nicotine to kill an adult human if ingested.

In QuitNet's experience, smokers who switch to e-cigarettes have been more likely to relapse back to conventional smoking than abstainers, and ex-smokers with longterm quits have lost them completely after first succumbing to e-cigarette claims of safer-than-smoking. Ex-smokers in our own online community react negatively to promoters and/or users of e-cigarettes--so much so that we've had to place restrictions on discussion of them in the forums.

One of our greatest concerns is e-cigarettes' potential for renormalizing, even glorifying, social/recreational/therapeutic nicotine use. Worse, they may act as 'bridge' products back to smoking for the already-quit, or as 'starter' products' to attract non-smoking youth to nicotine addiction. The evidence so far indicates that they will have little positive effect on longterm abstinence rates, and will contribute to higher relapse rates among already-quitters.

Topics: Healthy Living Smoking Cessation Cigarette Nicotine replacement therapy E-Cigarettes NRT QuitNet Smoking

Insiders: Blue Zones Project™

Jennifer Rudloff

According to the 2010 Gallup-Healthways Well-Being Index®, Iowa currently ranks as the 19th healthiest state in the nation. Although that puts Iowa in the top half, there is room for improvement. Today, Iowa scores well on emotional health, physical health and access to basics such as safe surroundings, financial resources, strong community and health care services. Progress needs to be made on healthy behaviors such as exercise and eating habits, as well as improving overall work environments.

Enter The Blue Zones Project: a public/private collaboration between Wellmark Blue Cross and Blue Shield and Healthways to help make Iowa #1 in the nation for well-being as measured by the Gallup-Healthways Well Being Index. In these video's John Forsyth, Chairman and CEO of Wellmark, and Dan Buettner, Author of Blue Zones, talk about this landmark initiative.

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Topics: Well-Being In the News Dan Buettner Health Community Well-Being Index Healthiest State Wellness Healthways Iowa Government Wellmark Blue Cross Blue Shield Blue Zones Project

Insights from the Well-Being Index: October 2011

Jennifer Rudloff

Kent Raymond, ETL Analyst at Healthways, paints a portrait of America's Well-Being, and reveals trends across the nation as he discusses the latest findings from the Gallup-Healthways Well-Being Index ®.

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To see the complete report, click here.

For more on the Gallup-Healthways Well-Being Index, visit

Topics: Healthy Living Basic Access Predictions Work Environment Physical Health Emotional Health Well-Being Index Life Evaluation Healthways Wellness Trends Gallup

Well-Being at Work: Tips for Working-In Your Work-Out

Jennifer Rudloff

Time (or a lack there of) is a common excuse for not exercising - but you don't have to let busy get in the way of you taking care of yourself. There are simple ways you can incorporate fitness into your daily routine. In this video Gloria Lunn, a personal trainer and health coach at Healthways, shares one of her favorite tips to work-in your work-out, even on busy days.

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Topics: Healthy Living Well-Being Exercise Weight Loss Fitness Health Wellness Healthways

Five Game Changing Trends in Healthcare

Jennifer Rudloff

While we can’t predict the future, we think that it’s always important to keep a watchful eye out for trends in our industry. The field of healthcare is one that constantly evolves, as new implications constantly arise for doctors, patients, and well-being support providers like us.

Below is a list of several major emerging trends in healthcare that we think could be truly ground breaking. In our opinion, these trends – for which we’ve begun to see the seedlings – could be total game-changers, for Healthways and for the industry at large.

Here are five patterns in the healthcare industry that we think have the potential to stick around, at least for the time being:

  1. Health plan preparation for state insurance exchange implementation, which is projected to cause significant disruption of individual and small group fully insured businesses;
  2. Change from a volume-based to a value-based payment system, a change which comes with the associated shift of financial responsibility (and thus, risk) for cost and quality from health plans to providers;
  3. Increasing payer requests for comprehensive, integrated solutions, as more insurance clients aim to address longitudinal health risks and care needs for total populations;
  4. Adoption of population health management on a global scale, by both foreign government and foreign private sector health organizations; and
  5. Recognition by large employers of the expanded value of improved well-being, to reduce medical cost and improve individual and company productivity and performance.

This is just the beginning of changes we expect to see in the industry; momentum has already begun to pick up, and we’re excited to see how the space evolves. Particularly due to the upcoming 2012 presidential elections, our healthcare industry may be in its most malleable state ever – and this may hold direct or indirect impact upon our well-being as a country.

So, what do you think? How have you witnessed these industry trends in your own healthcare experiences? What are some other major changes in healthcare that you see on the horizon? Let us know by leaving comments below or on our Facebook page!

Topics: Healthcare Health Healthways Trends in Healthcare Health Plan & Health System

Women's Well-Being: Behind the Series

Jennifer Rudloff

Think you know the happiest woman in America? Well we do! Based on findings from the Gallup-Healthways Well-Being Index®, the Healthways Science Team identified distinct characteristics that contribute to high well-being for America’s largest demographic, Baby Boomer Women. In a four part series – USA Today found ‘the happiest woman in America’ and use her life as an example as they explore what well-being means in work, health, and relationships for this generation of boomers.

I wanted to take some time to dive in to the data behind the series and discuss it's implications and associated action steps for each topic:

If you missed the series in USA Today - be sure to check out the stories:

Meet the happiest woman in America
Learn about work from ‘the happiest woman’
Learn about health from ‘the happiest woman’
Learn about relationships from ‘the happiest woman’

ABC World News also featured this series during 3 nights of their broadcast. Be sure to check out their coverage on well-being and health.

Topics: Healthy Living ABC World News Relationships Well-Being In the News Happiest Woman in America Business Performance Health Well-Being Index Baby Boomers USA Today work life balance Gail Sheehy

Ragnar Relay, Tennessee

Jennifer Rudloff

According to the Gallup-Healthways Well-Being Index®, Tennessee is ranked as the eleventh worst state in the nation in overall well-being. In terms of physical health, Tennessee falls below the national average, ranking among the bottom five states in the country with the highest rates of diagnoses for high blood pressure (36.1 percent), high cholesterol (29.7 percent) and diabetes (14 percent). In addition, 28.9 percent of the population is obese and only 50.2 percent of Tennessee residents exercise on a regular basis (three or more times a week for 30 minutes or longer each time.) Tennessee's state of health and well-being is hurting us, and while it's a long road ahead, we think it's time that we make a change.

Healthways is a proud sponsor of the second annual Tennessee Ragnar Relay. Today, hundreds of runners took their mark in Chattanooga, TN on a journey toward Nashville….on foot. Teams of 12 runners divide the journey into 36 legs across the Volunteer State. It’s a great chance for our Healthways colleagues and runners to improve their social, emotional, and physical well-being with groups of friends and a little healthy competition. Ragnar aims to inspire people and communities through a visual model of fun, healthy exercise and sportsmanship. Teams are taking a great step towards reducing obesity and encouraging Tennesseans to get active and take advantage of the long-term benefits of a healthy lifestyle.

Last week, Dr. Fitness interviewed Healthways own Reggie Ramsay. They talk about the health and fitness of our nation and about Healthways partnership with Ragnar. Be sure to listen to the audio podcast below!


If you see any of the Ragnar runners this weekend, be sure to offer them some encouragement!

Topics: Healthy Living Well-Being Ragnar Well-Being Index Dr. Fitness

It's No Vator November - We're in - Are you?

Jennifer Rudloff

Exercise isn’t a destination, its part of the journey. Just can’t get to the gym or make time in your schedule for even 30 minutes of activity? Take the stairs! And take the initiative to start the movement – literally – by inviting a few friends along. And put that commitment in writing – in an email – in a text – in a tweet…..saying it “out loud” makes it real – “for the month of November I am going to bypass the elevator and take the stairs – No Vator November!” Share your commitment with 5 or more of your friends and ask them to share it with their friends. That’s what happened here at Healthways…one person shared his commitment with friends and asked them to pass it on. The result? Hundreds of colleagues joined the movement and have taken to the stairs!

What difference can a few flights of stairs make? According to Dr. Alan Hedge at Cornell University, only 34 extra calories a day can be the tipping point. In looking at the rise of obesity in America over the last decade, Dr. Hedge found it really was that simple. Just 34 extra calories a day can add 5 or 6 pounds a year! Simple lifestyle changes – adding more movement to your day – can burn those 34 calories and more. Just two or three flights of stairs daily will offset those 34 calories, depending on your weight and the intensity of your stair climb. Ramping up to six flights of day could help you trim off pounds!

Your work environment is a great place to start the movement. You don’t need any special equipment or dedicated space. Little nudges like taking the stairs instead of the elevator to a meeting might get even the most exercise adverse employee moving. After all, do you want to be the only one heading to the elevator when the rest of the team is taking the stairs?

Optimizing the physical environment is key to supporting well-being in the workplace and creating a Culture of Health. Sounds expensive, doesn’t it? It doesn’t have to be. Thinking outside the box – or in this case – outside the elevator – is all it takes to start the movement in your workplace.

Topics: Healthy Living Well-Being Exercise Workplace Well-Being Health Take the Stairs Stairs Dr. Alan Hedge