You Can Be Smoke Free!   Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia: Anthem Health Plans of Virginia, Inc. (serving Virginia excluding the city of Fairfax, the town of Vienna and the area east of State Route 123.).  In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi") underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare") underwrites or administers the HMO policies; and Compcare and BCBSWi collectively underwrite or administer the POS policies. Independent licensees of the Blue Cross Blue Shield Association. ® ANTHEM is a registered trademark. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.

"Quitting smoking is easy. I've done it a thousand times.” Mark Twain

Objectives Understand the facts about the dangers of smoking and the benefits of stopping Raise awareness about your body’s response to being a non-smoker Develop a personal action plan Manage weight gain and other possible consequences to quitting Make sure you make participants aware of the resources available through their provider (EAP or work/life) to support their efforts to quit smoking.

Tobacco use accounts for 30% of all cancer related deaths Smoking causes 87% of all lung cancer deaths COPD is the 4th leading cause of death in the U.S. Tobacco causes nearly 1 in 5 deaths Lives are shortened by more than thirteen years due to smoking Cigarette-ignited fires are the leading cause of home fire deaths in the United States, killing 700 to 900 people annually Scary Statistics Source: American Cancer Society, American Lung Association, National Fire Protection Association COPD is Chronic Obstructive Pulmonary Disease. It is a combination of emphysema and chronic bronchitis . 90% of all smokers get some degree of COPD. About half of the people who keep smoking will die because of it. In the United States, tobacco causes nearly 1 in 5 deaths, killing about 443,600 Americans each year. Smoking is the single most preventable cause of death in our society. Based on current patterns, smoking will kill about 650 million people alive in the world today. If these patterns continue, tobacco-caused deaths worldwide are expected to increase from about 5.4 million per year today to about 10 million per year by the 2030s. Most of these deaths will happen in developing countries. The CDC estimates that males lose 13.2 years, females lose 14.5 years

Reassuring Facts 20 minutes after quitting Your heart rate and blood pressure drop. 12 hours after quitting The carbon monoxide level in your blood drops to normal. 2 weeks to 3 months after quitting Your circulation improves and your lung function increases. Source: US Surgeon General's Report, 1990

Reassuring Facts (cont.) 1 to 9 months after quitting Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection. 1 year after quitting The excess risk of coronary heart disease is half that of a smoker's. Source: US Surgeon General's Report, 1990

More Reassuring Facts 5 years after quitting Your stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting. 10 years after quitting The lung cancer death rate is about half that of a person who is still smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas decreases. 15 years after quitting The risk of coronary heart disease is that of a non-smoker's. Source: US Surgeon General's Report, 1990

What does it feel like to quit? Withdrawal symptoms can include any of the following: dizziness (which may only last 1 to 2 days after quitting) depression feelings of frustration, impatience, and anger anxiety irritability sleep disturbances, including having trouble falling asleep and staying asleep, having bad dreams or even nightmares trouble concentrating More on next slide.

What if feels like to quit (cont.) restlessness or boredom headaches tiredness increased appetite weight gain constipation and gas cough, dry mouth, sore throat, and nasal drip chest tightness If anything feels scary or out of the ordinary please contact a health professional immediately! Sounds awful, right? Remember that all of all these symptoms will come and go. Some for good. The important thing is that you are choosing your health over smoking. A longer, better smoke free life over a compromised existence. Remind participants how quickly their bodies respond to being a non smoker.

Positive Effects on Simple Daily Pleasures Heightened sense of taste You can smell things again – flowers, fresh cut grass, ocean breezes Personal hygiene gets a boost: no more smelly clothes, hair or skin Teeth and nails stop yellowing Breathing improves so that you can do ordinary activities Extra cash! $4-5/pack adds up fast! Cleaner home, cleaner car A 40-year-old who quits and puts the savings into a 401(k) could save almost $250,000 by age 70

Personal Action Plan Preparing to Become a Non-Smoker Pick a target start date Tell everyone you know so you can garner support Get rid of all smoking reminders/triggers (matchbook collections, favorite lighters, etc.) Keep a list of times/settings/people who trigger an urge so you can avoid them Get a complete physical and a dental check up Clean your house/car/office Brainstorm a list of things to do instead of smoking Reflect on past successes and failures It is so important to remember that everyone is different and that each time you quit is going to be different. You must be willing to acknowledge that you can get a smoking related disease that is deadly.

Act Like a Non-smoker Practice healthy stress management techniques Swap the unhealthy habit of smoking for a healthy one like walking Keep your mouth busy with gum, water, healthy snacks Avoid other smokers and smoking areas Remind yourself with words and visuals that you are a nonsmoker Reach out for support when you need it

Incorporate more fitness into your daily routine Practice healthy eating habits: portion control, low fat choices, plenty of water Incorporate more fitness into your daily routine Stay away from the naysayers who doubt your success Cravings pass – give yourself some time to think before you act Reward yourself with non-food treats Distract yourself: take a shower, drink a cup of tea Develop new hobbies and interests that don’t remind you of smoking MANAGING WEIGHT GAIN

BE A NON-SMOKER Acknowledge your hard work and how far you have come Join or start a support group in your community or at work Continue your new healthy habits: eating right, exercise, stress management Focus on the positives and all that you have GAINED from losing the smoking habit Remind yourself how good you feel since quitting!! Review your Personal Action Plan BE A NON-SMOKER

Resources Toll-free number: 1-800-227-2345 Web site: www.cancer.org American Heart Association Toll-free number: 1-800-AHA-USA-1 (1-800-242-8721) Web site: www.americanheart.org American Lung Association Toll-free number: 1-800-LUNG-USA (1-800-586-4872) Web site: www.lungusa.org Tobacco cessation program "Freedom from Smoking Online" at www.ffsonline.org National Cancer Institute Cancer Information Service Toll-free number: 1-800-4-CANCER (1-800-422-6237) for cancer information Toll-free smoking cessation/tobacco line: 1-877-448-7848 Web site: www.cancer.gov Smoking cessation Web site: www.smokefree.gov Nicotine Anonymous Toll-free number: 1-877-879-6422 Web site: www.nicotine-anonymous.org Centers for Disease Control and Prevention Toll-free number: 1-800-CDC-INFO (1-800-232-4636) Web site: www.cdc.gov Tobacco information at www.cdc.gov/tobacco/quit_smoking/index.htm

Anthem Employee Assistance Program Face-to-face counseling sessions Legal/Financial consultations Child/Eldercare consultation & referrals Daily life resources ID theft recovery Free credit monitoring Tobacco cessation: coaching & online Comprehensive website Resources Self assessments Live-connect feature Health/wellness library Legal forms Call 855-223-9277 or go to our website at www.anthemeap.com Login: Commonwealth of Virginia

Thank you! Questions?