How Managers Can Address Smoking in the Workplace

The dramatic decrease in smoking over the last three decades is largely the result of a concerted educational effort regarding the associated health risks, and from a dramatic change in cultural attitudes regarding tobacco. In recent years, however, the impetus to quit smoking has been driven by the workplace.

When smokers could no longer light up at their workstations and were relegated to remote designated areas, using tobacco became increasingly inconvenient. In addition, nonsmoking co-workers have been emboldened and begun voicing their opposition to breathing secondhand smoke.

Awareness of the health risks and the freedom to voice disdain for tobacco use are now commonplace—and most businesses, restaurants, airlines, hotels and even some bars have banned smoking. So there has never been a better time to encourage smokers to quit.

Costs of smoking

Tobacco use increases the risk of heart disease, cancer, lung disease and other debilitating conditions, costing employers billions of additional dollars in medical care costs. Other tobacco-related costs incurred by employers include:

• absenteeism—smokers “call in” and miss more work due to health problems
• workers’ compensation payments and occupational health awards are higher for tobacco users
• tobacco users are less productive due to smoke breaks and health limitations
• accidents and fires (plus related insurance costs)
• indoor air pollution; cleaning and maintenance from secondhand smoke
• illness and discomfort for nonsmokers exposed to secondhand smoke

Benefits of a smoke-free workplace

• A well planned and carefully implemented effort by the employer to address the effect of smoking on employees' health and the health of their families shows the company cares.
• A smoke-free environment helps create a safe, healthful workplace.
• Direct health care costs to the company may be reduced.
• Maintenance costs go down when smoke, matches and cigarette butts are eliminated in facilities.
• Office equipment, carpets and furniture last longer.
• Workers who are bothered by smoke will appreciate the clean air.
• Managers are relieved when a process for dealing with smoking in the workplace is clearly defined.

While employees must take responsibility for their smoking and ultimately their health, it is in the best interest of managers to understand tobacco addiction and how to motivate and encourage tobacco users to engage in the quitting process.

Stages of change

There is now scientific evidence on how individuals change addictive behaviors such as smoking. In short, behavior change occurs in five sequential stages. They are:

1. Precontemplation is the stage at which there is no intention to change behavior. Individuals in this stage are unaware or inadequately aware of their problems.
2. Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about making changes, but have not yet made a commitment to take action.
3. Preparation is a stage in which people plan and prepare to take action.
4. Action is the stage in which individuals begin to change their behavior. This stage requires considerable commitment of time and energy.
5. Maintenance is the stage in which people work to sustain change and prevent relapse.

How to begin addressing tobacco use

1. Gather a small team of employees and managers for a brainstorming session on the topic of employee health and tobacco use. A former smoker and an employee assistance professional (EAP) would be valuable contributors.
2. Using the stages of change model, determine the current motivational climate for addressing tobacco use in the workplace.
3. Discuss ideas on how to move forward into the next stage. For example, if it is agreed that most tobacco-using employees are in the “precontemplation” stage, then increasing awareness of the problem is a viable objective.
4. Discuss what resources are available within the organization—health promotion material, EAP support, local experts, etc.
5. Ask participants for the names of additional employees and managers who may want to get involved. More is better!

Many companies have developed successful smoking cessation programs as stand-alone modules or as part of an overall worksite wellness campaign. Examples include:

• making on-site smoking cessation and wellness programs or other support groups available at work
• sponsoring or subsidizing health club memberships
• working with health providers to develop incentives to encourage cessation
• implementing a tobacco cessation program

Remember that one of the most important factors in the success of any worksite health program is the extent and nature of support that is given to the program by management. Without tangible and visible support even the most well-intentioned programs are doomed to fail.

Sources: Warner, Kenneth E., Smith, Richard J., Smith, Dean G., Fries, Brant E. (1996) "Health and Economic Implications of a Work-Site Smoking-Cessation Program: A Simulation Analysis." Journal of Occupational and Environmental Medicine. 38(10):981–992; Changing for Good by J.O. Prochaska, J.C. Norcross, and C.C. DiClemente. William Morrow, 1994.

By Drew Edward, EdD, MS
© 2005 Achieve Solutions