A comprehensive, employer-supported tobacco cessation program can reduce the costs related to employee tobacco use and improve employee productivity, health and quality of life. You are aware of the business rationale as well as the critical elements for program success. Now, it’s time to apply this information to your unique workplace.
With a strong EAP in place, you have already provided a valuable foundation for a tobacco cessation program. As described in the “Helping Individuals” section, the EAP is available to conduct a detailed assessment, facilitate linkages with available resources, and provide counseling and support to those who call.
This section will help you develop an integrated workplace program that involves key constituencies within the organization. We will review suggestions to enlist senior leadership, establish a workgroup and design a tobacco cessation program.
Enlist senior leadership support
The success of the tobacco cessation program will require strong support from senior leadership as well as corporate communications and human resources to facilitate broad communication efforts. With senior leadership support, the initiative will assume a prominent role within the organization and create cooperation from all levels.
To begin to generate that support, try to find senior leaders who have a personal connection with this issue or who already have demonstrated interest in a comprehensive tobacco cessation program at the workplace. See if any have been involved in a tobacco cessation program with a former employer. These executives can help you gain the support of other leaders.
To support your efforts to make the business case with executives, ValueOptions has prepared a presentation that you can customize for your organization. We’ve also written a sample employee memo that can be customized and used to demonstrate senior management commitment.
Establish a workgroup
Also critical to the success of the tobacco cessation initiative is the formation from the outset of an interdisciplinary workgroup. Its presence demonstrates organizational commitment and creates the structure for taking action.
To ensure that the program meets the needs of various constituencies within the company, you may consider including representatives from among the following groups:
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corporate communications
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employee assistance program
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employee population (tobacco users, former users and those who have never used)
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facilities
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finance
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health and safety
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human resources/benefits
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management
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medical
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legal
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operations
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union(s)
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vendor partners such as your behavioral health partner, physical health partner and/or tobacco cessation partner
The function of this group is not only to create a program for your organization, but also to meet regularly to continuously evaluate the program, identify trends and enhance the program.
Design your program
This section describes actions your workgroup might want to consider at this stage:
Assessing the current situation, attitudes and opinions
Assess your company’s current policies, practices and employee attitudes using the following questions. Update your policies based on the findings of this review:
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What are the restrictions on smoking?
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Who is covered by the policy?
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When was the policy established, and why?
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What are the employees’ attitudes about the current policy?
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Do employees comply with the policy? If not, why not?
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Who is satisfied or dissatisfied? Why?
Let employees know that your organization is serious about protecting their health and safety, and that a workgroup has formed to review benefits, policies and cessation support. Give them an opportunity to express their views through available communication tools, such as the intranet, staff newsletter and team briefings. An open approach allows questions and concerns to be raised and addressed.
When consulting staff, you are asking their opinion, not seeking their permission. Expect some resistance but remember that protection of the majority should be your prime concern.
You also need to understand management’s opinion on the following:
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advantages and disadvantages of the company becoming entirely smoke-free or offering separately ventilated areas (the latter may be a necessary transitional stage)
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the use of incentives to encourage employees not to smoke or chew tobacco
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the provision of tobacco cessation programs
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company characteristics that will ease or support the modification of secondhand smoke (SHS) policies and cessation activities
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obstacles within the company that need to be considered before new SHS policies and cessation activities are implemented
Finally, review any state or local regulations on smoking in the workplace and get a sense of how other businesses in your area approach this issue.
Crafting and implementing a smoking policy
If you have a policy that addresses smoking at the workplace, your workgroup will review it with your new goals in mind.
If you do not have a policy, your group will develop one. A written policy on smoking at work:
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provides a clear statement of intent, legitimizes action on smoking, and provides a firm foundation for workplace tobacco control activity
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creates a framework for action
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minimizes the possibility of misinterpretation or misunderstanding of the organization’s position on tobacco, and in multi-site organizations, any differences in interpretation between sites
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provides a corporate document to which all employees (both existing and new), managers and contractors can refer
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demonstrates commitment to the health of everyone in the workplace
- justifies the allocation of resources to workplace tobacco control activity
With a smoking policy, you send a clear message to employees and the community: We care about the health and safety of our employees. When you couple this with support to help smokers quit, you strengthen the message and reassure smokers that the company is not trying to stigmatize them.
While many possible smoking policies exist, your workgroup will probably find that only two kinds are viable in today’s social and scientific environment:
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Smoke-free: Smoke-free environment in company facilities and vehicles. This can be extended to include all of the property or grounds of the employer.
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Separately ventilated areas: Smoking limited to separately ventilated smoking rooms or outside shelters. (This has its limitations—it may have adverse effects on smokers’ health and may not adequately protect nonsmokers from secondhand smoke; as well, the associated costs of building and maintaining such a space can be prohibitive.)
Some questions to consider in making your decision include the following:
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Given the employees’ interests, health and work environment, what policy will provide them the most protection?
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What policy will offer the greatest benefits to the company at the lowest cost?
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What policy will management find most supportable?
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What state or local/community ordinances exist governing smoking in public places or workplaces?
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What are the customers’ or the community’s expectations regarding a secondhand smoke policy, given the policies in other similar workplaces and public sentiments on this topic?
There are many sample policies that can be customized for your workplace; here is a model policy that can be modified to suit your organization’s needs: Model Smoke-free Policy.
The core items to include in your policy are:
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purpose
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link between the policy and cessation support and corporate values
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statement of where smoking is prohibited
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statement of where smoking is permitted (if applicable)
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statement on enforcement and consequences of noncompliance
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statement of support provided to employees who use tobacco
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a contact person for questions
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a process for review and post-implementation comments from employees
Be sure that your policy is in line with other company policies and procedures, such as code of conduct and health and safety practices.
After establishing your policy, communicate the policy and its rationale clearly, as well as sanctions for noncompliance. Implement the policy according to the agreed timetable. Monitor, enforce and adjust the policy if necessary. Compliance is typically high if employees have helped develop the policy and are well informed about its rationale.
The effect of implementing a smoke-free policy will be most immediate for employees who smoke. You can help them adjust to changes introduced by your smoking policy:
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Inform employees well in advance that a new policy is being developed—ideally four to six months prior to implementation.
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After the policy is implemented, let smokers know that you appreciate their efforts to comply with the policy.
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Offer tobacco cessation assistance.
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Ask nonsmoking employees to support and encourage smokers.
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Plan for continuing support of smokers who want to quit.
Assembling supportive programming for tobacco cessation
When you announce a new or revised smoking policy, many employees will want information and support to make their quit attempt successful.
Each company must decide what type of support fits the work situation best. These questions can help:
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How strongly does the company want to support employees who smoke?
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What resources are available in the company, community and elsewhere? The ValueOptions EAP, for example, can provide consultation to your organization, educational training and information for supervisors and employees, and services for those who want to quit. Your health plan also may have resources to offer. Another option is to sponsor a formal, structured tobacco treatment program that offers consistent and unlimited support over the course of a year, educational materials and access to nicotine-replacement therapy; ValueOptions can recommend a program with proven results.
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How do the employees who smoke feel about pending policies? What kind of support do they expect? How many might be interested in taking advantage of what the company offers?
Because not all smokers will make a serious attempt to quit at the same time, and not all smokers will respond to the same program or prescription for quitting, you should make a variety of methods and materials available. Smokers vary in their readiness to quit. Some may have quit and need support to stay away from cigarettes, some may be ready to try to quit, and others may still be thinking about it. Still others may not be ready to contemplate a cessation attempt.
The section, “About Tobacco Cessation,” provides information on the effectiveness of various cessation program elements—counseling, medications, communication, incentives, variety of resources, etc. Use that information to guide your review of what you want to offer your colleagues.
Reviewing employee benefits
Once you have determined your workplace smoking policy and the cessation support you want to offer, your workgroup should review your existing benefits plan to assess its coverage of tobacco cessation treatment. According to the Centers for Disease Control and Prevention, paying for tobacco use cessation treatments is the single most cost-effective health insurance benefit for adults that can be provided to employees. Keep in mind that first-dollar coverage (no cost to employees) of tobacco-use cessation treatment dramatically increases both the use of effective treatment and the number of successful quit attempts.
Both the Public Health Service-sponsored Clinical Practice Guideline, “Treating Tobacco Use and Dependence,” and the Community Preventive Services Task Force recommend that all insurers provide tobacco cessation benefits that do the following:
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Pay for counseling and medications, together or separately. It’s a good idea to include multiple options so that tobacco users can individualize the method that works best for them.
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Cover at least four counseling sessions of at least 30 minutes each, including proactive telephone counseling and individual counseling. While tobacco cessation classes are also effective, smokers are more likely to participate in one-on-one counseling programs, either telephone-based or face-to-face.
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Cover both prescription and over-the-counter nicotine-replacement medications and bupropion.
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Provide counseling and medication coverage for at least two tobacco cessation attempts per year. Relapse rates are high and some employees will make several attempts to quit. Keep in mind that each attempt moves the smoker farther along the path to quitting for good.
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Eliminate or minimize co-pays or deductibles for counseling and medications, as even small co-payments reduce the use of proven treatments.
You also might consider building in positive incentives and recognition programs to promote healthy lifestyles. For example, you could offer a discount on health premiums or extra cash in a flexible spending account to any smoker who completes a specified tobacco cessation program.
Finally, be sure to communicate clearly and often on these important benefits, to encourage employees to take advantage of the support your organization is offering them.
Keep in mind that your organization is investing in the health and safety of its workforce, and will reduce tobacco-related health care costs in the long run.
Please review the section, ”Strategy,” for guidelines and tools to help you create a communication strategy to reach current and quitting tobacco users, as well as managers and co-workers who can offer critical support to these individuals. You’ll find guiding principles, low-cost tips, tools and a sample timeline to help you plan your outreach.
Sources: “Coverage for Tobacco Use Cessation Treatments,” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; “Making Your Workplace Smokefree: A Decision Maker’s Guide,” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health; “Tobacco in the Workplace: Meeting the Challenges. A Handbook for Employers,” World Health Organization
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