{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:59:47Z","timestamp":1765889987602,"version":"3.48.0"},"reference-count":18,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"LLUH Risk Management","award":["Contract #1000332"],"award-info":[{"award-number":["Contract #1000332"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,4,3]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of the Loma Linda University Health (LLUH) BREATHE cohort is to test the efficacy of a novel method of continuously incentivising participation in workplace smoking cessation on participation, long-term abstinence, health outcomes, healthcare costs and healthcare utilisation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>In 2014, LLUH\u2014a US academic medical centre and university\u2014incentivised participation in a workplace smoking cessation programme (LLUH BREATHE) by lowering health plan costs. Specifically, LLUH introduced a Wholeness Health Plan (WHP) option that, for the smokers, continuously incentivises participation in nicotine screening and the LLUH BREATHE smoking cessation programme by offering an \u2018opt-in wellness discount\u2019 that consisted of 50%\u201353%\u2009lower out of pocket health plan costs (ie, monthly employee premiums, copayments). This novel \u2018continuously incentivised\u2019 model lowers annual health plan costs for smokers who, on an annual basis, attempt or maintain cessation from tobacco use. The annual WHP cost savings for smokers far exceed the value of short-term incentives that have been tested in workplace cessation trials to date. This ongoing health plan option offered to over 16\u2009000 employees has created an open, dynamic LLUH BREATHE cohort of current and former smokers (n=1092).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings to date<\/jats:title>\n                    <jats:p>Our profile of the LLUH BREATHE cohort indicates that after 5\u2009years of follow-up in a prospective cohort study (2014\u20132019), continuously incentivised smoking cessation produced a 74% participation (95% CI (71% to 77%)) in employer-sponsored smoking cessation attempts that were occurring less than a year after the incentive was offered. The cohort can be purposed to examine the effect of continuously incentivised cessation on cessation outcomes, health plan utilisation\/costs, use of electronic nicotine delivery systems, and COVID-19 outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-053303","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T07:56:50Z","timestamp":1652774210000},"page":"e053303","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cohort profile for the Loma Linda University Health BREATHE programme: a model to study continuously incentivised employee smoking cessation"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-2887","authenticated-orcid":false,"given":"Pramil N","family":"Singh","sequence":"first","affiliation":[{"name":"Loma Linda University Cancer Center\u2014Transdisciplinary Tobacco Research Program, Loma Linda University Health, Loma Linda, California, USA"},{"name":"School of Public Health, Loma Linda University Health, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Moses","sequence":"additional","affiliation":[{"name":"School of Public Health, Loma Linda University Health, Loma Linda, California, USA"},{"name":"Risk Management, Loma Linda University Health, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Shih","sequence":"additional","affiliation":[{"name":"School of Public Health, Loma Linda University Health, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Risk Management, Loma Linda University Health, Loma Linda, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"2025121604545553000_12.4.e053303.1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.18332\/tpc\/118237","article-title":"Participation in a workplace smoking cessation program incentivized by lowering the cost of health care coverage: findings from the LLUH breathe cohort","volume":"6","author":"Moses","year":"2020","journal-title":"Tob Prev Cessat"},{"key":"2025121604545553000_12.4.e053303.2","doi-asserted-by":"crossref","unstructured":"Fraser GE . Diet, life expectancy, and chronic disease: studies of Seventh-Day Adventists and other vegetarians. 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Statistical methods for rates and proportions. 2nd edn. New York: John Wiley & Sons, 1981."},{"key":"2025121604545553000_12.4.e053303.13","unstructured":"Hardle W . Non parametric regression. Cambridge University Press, 1990."},{"key":"2025121604545553000_12.4.e053303.14","doi-asserted-by":"crossref","first-page":"570458","DOI":"10.3389\/fpubh.2020.570458","article-title":"Pilot feasibility study of incorporating whole person care health coaching into an employee wellness program","volume":"8","author":"Nelson","year":"2020","journal-title":"Front Public Health"},{"key":"2025121604545553000_12.4.e053303.15","doi-asserted-by":"crossref","first-page":"15549","DOI":"10.1073\/pnas.1011277108","article-title":"Markov model of smoking cessation","volume":"108 Suppl 3","author":"Killeen","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2025121604545553000_12.4.e053303.16","first-page":"1513","article-title":"Quitting smoking among adults","volume":"60","year":"2011","journal-title":"Weekly Morbidity and Mortality Report"},{"key":"2025121604545553000_12.4.e053303.17","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1540"},{"key":"2025121604545553000_12.4.e053303.18","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntaa082"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-053303","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:55:06Z","timestamp":1765889706000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-053303"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,21]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bmjopen-2021-053303"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-053303","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}