"Smoking-cessation is the hottest program for us right now. It's the first thing employers are asking us about," says Gregg Lehman, chief executive of disease-management company Gordian Health Solutions.

Smoking costs an estimated $76 billion in healthcare and $82 billion in lost productivity each year, but employers have been much more willing to cover mammograms, cholesterol screenings, and other preventive services than stop-smoking programs. A 2004 survey by the Society of Human Resource Management found that less than one in three employers covered smoking-cessation programs.

Some employers have been scared off by relapse rates or because they believe the long-term health consequences of smoking won't affect them financially. But the Medicare move has prompted many to take a second look at providing such benefits. The Kaiser Permanente Center for Health Research and the industry group America's Health Insurance Plans are helping employers decided with an online tool that calculates how quickly investments in smoking cessation will pay off for companies (often within two or three years, experts say).

"The direction is definitely toward more coverage, and it's following the evidence that it works," says Michael Fiore, director of the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School.

Examples of companies paying for smoking cessation include AmeriGas Propane Inc., which waives copays for prescription antismoking drugs, provides disease-management services, and contributes up to $200 per employee for community-based cessation programs.

Destination Harley-Davidson of Tacoma, Wash., has seen eight of its 90 workers quit smoking since the company began paying for cessation services in 2001, and productivity has shot up thanks to fewer sick days, less fatigue, and the elimination of smoking breaks. Owner Ed Wallace Jr., said the benefits have far exceeded the $5,000 annual cost of the programs. "I wish I'd been doing this from day one," he said.

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