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Wellness: Issues of Obesity and Tobacco Use—A Cultural Shift Can Make an Impact

June 28, 2012

Colleen Reilly, Nelnet Director of Wellness & President of Total Well-Being

Forty-two percent of Americans are on track to be obese by 2030, according to the Wall Street Journal in May 2012.

In an ambitious effort to combat the rising rate of obesity, on May 30, New York Mayor Bloomberg announced plans to ban the sale of large sodas and other sugary drinks at restaurants, movie theaters, and street carts. This created quite a bit of controversy, but perhaps we need more policy implemented, such as the soda ban, and a strong shift of the cultural norm to protect us from ourselves.

While tobacco use is still a leader in preventable deaths each year, we have decreased the national smoking rate from 50% to 20% over the last 50 years. With numbers this successful, perhaps we could apply a few of the same strategies used in tobacco cessation toward slowing the obesity epidemic.

Since 1965, interventions to reduce smoking have been numerous. Even though people recognize the dangers of smoking, the causal connection between smoking and premature death is not simple; there is a reasonable chance that many smokers will only suffer minor health problems. This probably reduces the motivation to try to stop smoking. This is also true with obesity. Although people know obesity can lead to Type II diabetes, cardiovascular heart disease, stroke, sleep apnea, plus many more avoidable, costly conditions, they just risk it anyway.

In addition to public education and awareness campaigns of tobacco-causing health conditions, including mortality, other interventions that have been effective include the financial impact tobacco use has on a person’s budget, as well as social disapproval. People do change their habits when their pocket book is affected.  Also, the social disapproval is apparent since smoking has been limited in bars, restaurants, and other public venues. We also now know that the concern over the harm smoking can cause to others can influence behavior change.

All of these strategies may be worth using in the fight against obesity. So, before you discount Mayor Bloomberg’s plan to ban the purchase of large sugary drinks in New York, just be open-minded that something has to be done.

LiveWell Colorado is doing a great job educating Coloradoans about what is a healthy weight and that simply because someone doesn’t look overweight or obese doesn’t necessarily mean that person is healthy. Importance should be placed less on our looks and more on our health, productivity, children, and communities.

Sometimes it takes pulling on the heartstrings of people to get them to realize that if they don’t take care of their own health, they will become a financial and emotional burden to those around them and to our country as a whole. However, more importantly, they won’t be around for their children, grandchildren, family, and friends!

We can do an unlimited number of things to help change behavior from a policy and environmental standpoint, such as implementing taxes on sugary and unhealthy foods and banning the advertisement and promotion of certain foods. However, at some point, people have to become aware and intrinsically motivated to live a better, healthier, more productive life, and take accountability for themselves and their lifestyle choices. People can change with the right resources, tools, strategies, support networks, and incentives; and companies, as well as the government, can help.

There is no magic bullet—lifestyle change takes time, but it is possible. Take a look at how Nelnet is making a difference.

The trend for tobacco use at Nelnet has declined significantly by 73% over the past six years.


2005: 22% tobacco use - Implemented first assessment and screening 
2006: 20% tobacco use - Education and awareness campaign about the benefits of quitting tobacco use
2007: 19% tobacco use - Implemented online and telephonic tobacco cessation program
2008: 15% tobacco use - Added free Nicotine Replacement Therapy and RX aids for tobacco cessation participants
2009: 9% tobacco use - Implemented social networking solution to aid in behavior change; Smokers pay 20% more on health care premiums
2010: 8% tobacco use - Tobacco-free campus, tobacco-free themed wellness challenges, Great American Smoke Out
2011: 6% tobacco use - Implemented results-based wellness program requiring participants to be tobacco-free or enrolled in a cessation program in order to be eligible for the 10–20% premium reduction based on biometric results; Added tobacco question on job application

Nelnet has made a big improvement with tobacco usage; however, there is still opportunity for improvement and to change lives. Quitting tobacco use is hard to do, but employees are tackling this challenge each and every day, and overcoming obstacles, building the resilience and strength to stay tobacco-free, and creating the social support needed to sustain the change.

I continue to believe that by helping people identify their underlying emotional drivers, it can help people take the first step in tackling their tobacco addiction, weight management issue, or even reversing a separate chronic health condition.

Cynthia Sims, a Senior Risk Analyst within the Operations Risk Management Department at Nelnet, quit smoking after 30 years of tobacco use. It starts with one step. Why wait; you have one life and you own it!

“I started smoking when I was 18 years old. I have tried to quit many times over the past 30 years. When Nelnet implemented the tobacco-free premium credit, at first I was frustrated, but then I realized this may be the final push to get me to finally quit for good. I took advantage of every tobacco cessation program available. I used the employee assistance program to get the emotional support and skills needed to avoid lapse and relapses, and I even used the Tobacco-Free challenge on This was one of the hardest habits to break, but with such a supportive culture at work and at home, I am tobacco-free and have never felt better in my life physically, mentally, financially, and personally!  Thank you, Nelnet, for caring about me and helping me care about myself.”

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