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Tobacco 101

Are tobacco surcharges legal? Can my employer stop me from smoking?
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Yes, tobacco surcharges are legal. Under the Affordable Care Act (ACA), group health plans and self-insured employers can charge tobacco users up to 50% more for their health insurance premiums than non-tobacco users. When they do this, it is called a tobacco surcharge.

While employers and health plans cannot make someone stop smoking if a surcharge is in place, tobacco cessation programs are a way for a surcharge to be removed without requiring the individual to stop smoking.

How can companies help stop tobacco use (smoking, vaping, and other forms of tobacco)?
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Companies can help tobacco-using members by offering a comprehensive digital tobacco cessation programs within their wellness program. Programs offered should be designed to engage, be flexible, motivate and provide behavioral therapy to members to help them throughout their entire reduce and quit journey.

What makes Breathe Pivot a different and effective smoking cessation program? What resources are included?
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Pivot Breathe is designed for all people who use tobacco and nicotine. We help Pivot Breathe members understand their habits, routines, and triggers that lead to using tobacco products, helping develop the motivation and confidence needed to try to — and eventually — quit. If a person does decide to quit, we'll help them by equipping them with the best quit strategies and a peer-based community for support.

Pivot Breathe's tobacco cessation program delivers evidence-based behavioral strategies, a clinically-proven Breath Sensor, dedicated coaching, and NRT - all seamlessly connecting within the convenient mobile app. Built by physicians, behavioral psychologists, and engineers using the latest in digital health technologies, Pivot Breathe delivers the most effective tobacco cessation strategies on the market today, allowing members to rethink how they can quit. Our solution is highly empathetic, non-judgmental, and proven to build skills to help members achieve their goals.

Employers and health plans that implement Pivot Breathe gain access to our Member Enrollment Marketing team, who help in achieving between 5-10X enrollment. This is done with seasonal campaigns to drive awareness and engagement with the Pivot program. Additionally, clients benefit from easy implementation, clinical validation, robust reporting and metrics, in addition to multiple budget options to optimize wellness program activities.

What forms of tobacco and nicotine does Pivot Breathe support?
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All of them! Cigarettes, cigars, vaporized nicotine (nicotine derived from both tobacco plants and synthetic nicotine), chew, nicotine pouches, hookah, and more.

Why is clinical validation important when selecting a tobacco cessation program?
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Tobacco use is a chronic condition — much like diabetes or hypertension. As with any chronic condition, the program utilized as a benefit-offering should have proven results to ensure trustworthiness and intent to yield the benefits that those who use the program look for. That's why Pivot Breathe's program and Breath Sensor are both clinically-validated.  

Learn more from our own Jen Marler, MD, Vice President of Clinical and Medical Affairs at Pivot.


How does the Breath Sensor work?
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The Breath Sensor measures the amount of carbon monoxide in your exhaled breath* (CO is one of the toxins in cigarette smoke).

Using the Breath Sensor takes approximately 30 seconds. You’ll inhale then blow into the sensor, and the results can be viewed directly on the Breath Sensor. For the best experience, you can pair the Breath Sensor to the app to learn even more!

The more you use your Breath Sensor, the more you’ll understand your CO levels and how they are affected by your smoking. You can set up your Breath Sensor to remind you to give samples with vibrations or beeps.

*Indications for use: The Breath Sensor is a breath carbon monoxide monitor intended for single-user use by cigarette smokers as an educational and motivational tool to inform the user about how breath carbon monoxide levels are affected by smoking behavior. The device is not intended to be used with other inhaled combustible products.

Why do you need to know about my tobacco habits?
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Getting a sense of how many cigarettes you smoke or how often you smoke, vape, or use other nicotine products helps Pivot Breathe personalize many of the lessons members see throughout their journey. It makes the content and information provided more relevant and personalized.

Who receives a Breath Sensor, and how is it delivered?
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Members who use combustible tobacco exhale carbon monoxide (specifically from cigarettes) and, as a result, qualify for the Breath Sensor. As soon as members register for Pivot Breathe, they have access to order the Breath Sensor directly within the mobile app for shipment to their preferred address. Once shipped, an email from Pivot with shipment tracking information will be sent.

What's required to get started with Pivot Breathe?
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All that's required is a compatible iPhone (iOS 14.0.0 and later) or Android (6.0.0. and later) mobile device. Simply download the Pivot Breathe mobile app from the Apple or Android app store, and register following the steps provided by your employer or health plan to get started immediately.  

If you are someone who smokes, once you register, we'll mail you your Breath Sensor. Once your Breath Sensor arrives, no additional hardware or software is needed.

Is information shared within the Pivot Breathe mobile app private?
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Yes. The Pivot Breathe program is HIPAA-compliant, meaning our software and devices comply with federal standards to protect sensitive patient (member) health information from being disclosed without their consent or knowledge. Learn more by reading Pivot's privacy policy.

How does Pivot Breathe support reasonable alternative programs?‍
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Pivot Breathe provides robust demographic and reasonable alternative reporting to clients that details enrollments, tobacco behaviors, engagement, quit progress, satisfaction scores, and more!

What regulations and standards is Pivot compliant to?
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Compliance is always top of mind at Pivot and is reflected in a number of ways. All features of the Pivot Breathe program fall within HIPAA-compliant standards. We never disclose member health information without explicit consent and knowledge. Additionally, the Breath Sensor has achieved FDA 510(k) clearance, meaning this medical device has been scrutinized by expert reviewers and deemed safe and effective within the intended use.

Pivot is SOC-1 Type 1 and SOC-2 Type 1 compliant.

How do I receive NRT? How will I know which NRT to choose? Will I receive guidance on how to use NRT?
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Nicotine replacement therapy (NRT) is shipped directly to the Pivot Breathe member's address of choice. Pivot Breathe coaches will provide guidance on strength, type (gum, lozenge and patch), direct members to in-app lessons, and provide details on how to use NRT based on each member's unique quit journey needs and goals.

Can Pivot Breathe improve my enrollment?
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Pivot Breathe clients see a 5-10X increase in enrollments over other tobacco cessation programs. Actual client numbers vary and will be based on defined, specific goals.

Our dedicated Member Enrollment Marketing team develops turn-key and custom marketing programs which include evergreen resources to introduce Pivot as a wellness benefit offering, seasonal campaign updates to keep Pivot Breathe top of mind throughout the year, and innovative solutions to drive best-in-class results.

Can Pivot Breathe help me if I use more than one form of tobacco?
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Yes! Based on a recent study, more than 56% of Pivot Breathe members use multiple forms of tobacco. Our solution not only supports those looking to quit smoking, but also supports those who use multiple forms of tobacco and/or vape.

Pivot Breathe members can configure their tobacco type (use) settings at any point, take lessons on reducing usage, and develop quit strategies that take into consideration multiple forms of tobacco use.

Can Pivot Breathe be billed through claims?
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Yes! Pivot Breathe makes such an undertaking easier by offering the option to bill its services as claims to health plans. This enables employers to save valuable wellness dollars for other wellness-related services. Our partnership with Change Healthcare grants us access to over 2,400 health plans, allowing for quick tobacco cessation program implementation.


Does the Pivot Breathe app work on Android or iPhone devices?
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Yes. Pivot Breathe is available on both iOS (14.0.0. and above) and Android (6.0.0. and above).

I'm having difficulties logging in.
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Contact [email protected] for mobile app log-in-related issues.

My employer offers Pivot Breathe. How do I get started?
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If your employer or health plan offers Pivot Breathe, they'll have registration links with an access code that can be found in any reference material. If you cannot locate your registration access code, either reach out to your company or health plan, or contact customer service at [email protected].