Even though the smoking rate among
adults in the United States has
dropped from 42 percent in 1965 to 21 percent in 2006, tobacco use continues to
kill 440,000 Americans a year. What may be
more astounding is that secondhand
smoke kills an estimated 53,000 persons
each year. It is estimated that exposure to
secondhand smoke in the workplace kills
more people than any other occupational
hazard.
Secondhand smoke is a Class A carcinogen. State and federal governments have
strict laws to protect workers from all
other powerful carcinogens, but employers
are given much more leeway in protecting
their workers from secondhand smoke.
“Helping employees quit smoking has
evolved from a generous outreach effort to
a health and business imperative,” says
Michael O’Donnell, Ph.D., MBA, MPH.
Smart Business talked with O’Donnell
about how smoking cessation programs
can be instituted in the workplace.
What are the costs of employee smoking to
an employer?
In addition to the health problems caused
by smoking, the increase in medical costs
is estimated at $1,600 per year per smoker.
On top of that, employees who take three
10-minute smoking breaks a day are spending 15 eight-hour days of paid company
time a year away from the job to smoke.
What smoking-restriction policies are available to employers?
There are three options:
- Restrict smoking to designated areas.
This is a good start for companies that
have no restrictions, but it is very difficult
to keep the smoke in the smoking areas.
Also, smoke in confined smoking areas is
so concentrated that it puts people who
are forced to work in these areas at double
risk. - Establish smoke-free buildings. Not
only are you providing clean air in all
indoor work locations, you are also forcing smokers to go outside to smoke, which
is enough to convince some to quit and
most to smoke less. However, the main drawback is that smokers tend to congregate by the doors, which means that other
workers, customers and visitors have to
walk through the smoke. - Implement an entire campus as smoke-free. When employers create smoke-free
work environments, the benefit to workers
who were previously exposed to secondhand smoke is immediate. All workers now
have access to clean air to breathe and do
not have to worry about risking their
health just coming to work.
Is altering hiring practices appropriate?
A growing number of employers have
decided not to hire smokers, including the
American Cancer Society and the Union
Pacific Railroad. Not hiring smokers does
not directly benefit smokers, but it has
clear direct benefits in terms of worker
productivity and medical costs. A small
number of companies have fired employees who smoke. This has attracted much
visibility and numerous legal challenges.
How can you make these policies succeed?
Any new smoking policy should include
support, such as smoking cessation programs to help smokers quit. Implementing
a smoke-free workplace will increase the
number of people who try to quit. The key
to success is an approach that combines
expert advice and medication.
Regardless of the policy an employer
chooses, there are four factors that contribute to success. One, the leadership
team should have a unified message
regarding the policy and announce it to
employees. Two, employees, including
smokers and nonsmokers, should be
engaged to determine how to best implement the policy. Three, communication
efforts should focus on the importance of
protecting the health of all workers by providing clean air to breathe. And, fourth,
clear protocols should be in place to
enforce the policy.
What are the benefits to an employer of instituting a smoking cessation program?
Worker productivity should increase as
soon as a smoker quits because he or she
is able to spend more time at work.
However, much of this productivity gain
will be offset by the struggles of overcoming the physical addiction to nicotine.
Many smokers who quit have very real
physical withdrawal symptoms, including
irritability, fatigue, insomnia, headache,
cough or sore throat. These symptoms can
make it difficult for some workers to focus
on work, so productivity may actually drop
for a few days. Showing compassion for
quitters during this time will go a long way.
Smokers have higher medical costs
because they are sick more often and
more severely. Smokers who quit because
of an acute health problem may actually
see their medical costs increase in the first
year or two because of the disease, not
because they quit smoking. It will take
time for former smokers to recover, and
their costs will drop as they heal. In fact,
these costs will drop to the costs of non-smokers over a period of five years for former smokers who do not have chronic diseases and 10 years for those who have
chronic diseases.
MICHAEL O’DONNELL is a Ph.D., MBA, MPH. For more information, contact William Modoono, senior writer, UPMC Health Plan at
[email protected] or (412) 454-7781.
