A Comprehensive Approach to Smoking Cessation in the Workplace Start Living Healthier.

A Comprehensive Approach to

Smoking Cessation in the Workplace

Start Living Healthier

Smoking and Human Health

Smoking – An Addiction to Nicotine

Smoking & Productivity

Why Should Employers Help Employees Stop Smoking?

What Supports Can Employers Provide and What Supports are Ideal?


Background & Rationale


Background & Rationale

Cessation therapy and counselling is the most cost effective health intervention that an employer can provide.

Data on the impact of smoking on workplace health and productivity was limited.

Nicotine therapies were initially seen as magic bulletsto smoking cessation.

Access and evidence to support cessationcounselling were not available.

The effect of smoking on workplacehealth and productivity is currentlywell documented.


Smoking and Human Health“Canada has no choice but to adopt a new model of health care, a business model that encompasses both preventing and managing chronic disease.” (Conference Board of Canada)

Smoking is a major contributor to several chronic diseases: Cardiovascular disease, including stroke, heart attack, etc.

Cancer

Emphysema/chronic obstructive pulmonary disease

Diabetes

Smoking affects every system in the body

‘Smoke goes where blood flows!’



Tobacco Users are: Six and a half times more likely to die from lung cancer

than non-smokers

At double the risk for a stroke

At three times the risk to die from heart attack, than non-smokers

In Canada, smoking accounts for a large percentage of deaths: 87% of lung cancer deaths – lung cancer is the leading cause of cancer

deaths for both Canadian men and women

30% of all cancer deaths

21% of all coronary heart disease deaths

10% of all infant deaths



Tobacco is the only legally available consumer product which kills people when used entirely as intended.

World Health Organization


Smoking – An Addiction to Nicotine


Nicotine Withdrawal

8:00 am - Had a cigarette

10:00 am - Experiencing withdrawal

12:00 pm - Reaching peak withdrawal


PHYSICALPHYSICAL

BEHAVIOURALBEHAVIOURAL

EMOTIONALEMOTIONALPSYCHOLOGICALPSYCHOLOGICAL


Smoking Cessation…Myths and Misconceptions

“Most smokers do not want to stop smoking”

FALSE! 91% of people who smoke have at least some desire to quit smoking and over half are seriously considering quitting within the next 6 months

“You just need willpower to stop smoking”

FALSE! Nicotine addiction is a complex addiction (a chronic relapsing condition). Supports, such as counselling and medication, are effective tools to help stop smoking



“Stopping smoking is a one time event”

FALSE! It takes an average of 4-5 attempts to stop completely. Each stop attempt has proven health benefits

“If you relapse, you’ve failed at your attempt to stop smoking”

FALSE! Stopping smoking is a process, not an event. Each ‘attempt’ should be considered a success and the employer should never stop supporting the process



“Smoking cessation only benefits the smoker”

FALSE! Non-smokers who work in smoke filled/exposed environments inhale the same 4000 toxic and carcinogenic chemicals as smokers. Cigarettes produce 12 minutes of smoke, and the smoker inhales only 30 seconds of smoke. The rest lingers in the air – and affects all who are exposed


Impact on the Workplace:Smoking & Productivity


Time Off WorkTime Off WorkDecreased Decreased

ProductivityProductivity

What’s the Impact on the Workplace?Employees smoking costs employers money!

Higher Insurance Higher Insurance CostsCosts

Employee Employee SmokingSmoking


What Does This Mean for Your Company?The Burden of Smoking

Enter number here(double click)

# of employees at YOUR company = 150

Smoking Breaks

Time Off Due to Illness

Life Insurance

Health Insurance

Smoking Area

TOTAL after 1 year

TOTAL after 3 years* based on a mean salary in Canada of $38,978 (2006)

101,317.50$

303,952.50$

87,010.50$

9,205.50$

2,394.00$

2,137.50$

570.00$


What Does This Mean for Your Company?Return on Investment

Calculation based on the assumption that counselling can be obtained free of charge from the Smokers Helpline as well as one-on-one or group counselling offered through occupational health and safety and/or local health authorities.

Enter Number of Employees at YOUR Company 150

6,033.77$

2,598.10$

3,435.68$

2.32$ * based on a mean salary in Canada of $38,978 (2006)

For every dollar spent for SCT reimbursement,the following SAVINGS is generated:

Potential savings derived from projected quitters over 3 years

Projected smoking cessation treatment (SCT) expenditures over the next 3 years

Potential net savings associated with this program over 3 years

Enter number here(double click)


Smoking & the Workplace… Totalling the Costs in Atlantic Canada

Annual Cost to Annual Cost to EmployersEmployers in in Nova ScotiaNova Scotia

Increased absenteeism $ 22.0 Million

On-the-job productivity losses $ 208.0 Million

Increased life insurance premiums $ 9.0 Million

Smoking area costs $ 10.0 Million

TOTAL $ 249.0 Million



Annual Cost to Annual Cost to EmployersEmployers in in New BrunswickNew Brunswick








Annual Cost to Annual Cost to EmployersEmployers in in NewfoundlandNewfoundland








Annual Cost to Annual Cost to EmployersEmployers in in Prince Edward IslandPrince Edward Island

Increased absenteeism N/A


Increased life insurance premiums N/A

Smoking area costs N/A

TOTAL N/A


Smoking & the Workplace… Totalling the Costs (annually)

$3,053

Smoking Smoking BreaksBreaks

Time Off Due to Time Off Due to IllnessIllness

$323

Life Life InsuranceInsurance

$84

Health Health InsuranceInsurance

$75

Smoking Smoking AreaArea

$20

TOTAL = $3,555 per Smoking Employee

Equal to an Average of 8.7% of PayrollStart Living Healthier

Smoking: Why Should Employers HelpEmployees Stop Smoking?


Blood pressure &

pulse return to normal

Oxygen levels return to normal

Risk of heart attack begin to

decrease

Sense of taste & smell improve

20 Minutes

8Hours

24 Hours

48 Hours


Improvements in lung

function and circulation

Risk of heart disease is

reduced by 1/2

Risk of lung cancer is

reduced by 1/2

Lungs improve capacity to

clear & reduce infection

Risk of stroke is reduced

Risk of heart disease is similar to a person who never smoked

2

Weeks

9

Months

1Year 5

Years

10 Years 15

Years


Why Help?Improve employee health

Smoking is the single most preventable cause of disease and death

Second-hand smoke is a health risk to non-smoking employees

Stop smoking programs are the single most effective andcost efficient support employers can provide to improveemployee health


What Supports Can Employers Provide - What is Ideal?


Range of Smoking Cessation Programs/SupportsComprehensive (greatest impact!)

Offering programs, supports and activities at the workplace (on-site, during work hours, etc.)

Facilitated

Working with outside agencies to deliverprograms, supports and activities off-siteand providing self-help materials

Education & Information Provision of educational self-help materials


Success

Only 2.5-5% of smokers Only 2.5-5% of smokers who attempt to quit who attempt to quit

unaided will succeedunaided will succeed

Without support, smoking cessation is challenging for employees.


Success

Medication and intense Medication and intense face-to-face counselling face-to-face counselling

increases successincreases success

The provision of workplace support will empower employees to work towards reaching their cessation goals.

Telephone counselling + Telephone counselling + medication increases medication increases

successsuccess


Compared to no support, Compared to no support, face-to-face counselling face-to-face counselling

increases successincreases success

Telephone counselling + one Telephone counselling + one session face-to-face session face-to-face

counselling increases successcounselling increases success

Smoking cessation Smoking cessation medication triplesmedication tripleslong-term successlong-term success

NRT doublesNRT doubleslong-term successlong-term success

Supporting Smoking Cessation

Smokers are 2-3 times more likely to succeed with supportthan without

Stop smoking rates increase when a workplace smoke free policy (restriction) is implemented

Over 26% of the smokers who wereprohibited from smoking at work hadstopped smoking in the past 6 months,compared to 19% without ano smoking policy


A Comprehensive ApproachConsiderations

There should be no cost to the employee to participate, and medications/nicotine replacement therapy should be subsidized

Cost



Program should be accessible:

Offered on-site /made available across multiple sites

Offered during work hours (not in lieu of normal breaks)

Provide a range of supports - Smokers Helpline, one-on-one counselling, group counselling, etc.

Accessibility



Smokers Helpline – free, confidential telephone support, tips, tools and advice from trained ‘Quit Specialists’

NS, NB, PEI - 1-877-513-5333www.smokershelpline.ca

NL - 1-800-363-5864 www.smokershelp.net

Accessibility



The provision of cessation supports should align with what your company can feasibly support (within its capacity)

Consider: How many employees smoke; employee interest in stopping smoking; how employees prefer to engage in cessation; employee expectations around workplace stop smoking supports; gauge employee interest in using the types of supports the employer plans to offer

Tailoring


Program Success:Representation & Engagement of Key Stakeholders

Engage stakeholders at all stages

Provide a voice to all workplace parties

Supported by management, but not management driven

A committee could be formed to representmanagement, employees, etc.


Program Success:Promotion The program needs to be effectively promoted to generate interest & encourage participation among employees

Employees should have the opportunity to provide feedback on program success and potential areas for improvement


Thank You


Thank you to CDHA for their participation in content development.

References

1. Canadian Cancer Society (2008). Effective Workplace Tobacco Cessation Interventions

2. Canadian Cancer Society (2008). Second Hand Smoke is Dangerous.

3. Canadian Cancer Society (2008). Tobacco Statistics in Canada;

4. Canadian Lung Association. Making Quit Happen.

5. Conference Board of Canada (2008). How Canada Performs: A Report Card on Canada Health Overview

6. Conference Board of Canada (2006). Smoking and the Bottom Line: Updating the Costs of Smoking in the Workplace

7. GPI Atlantic (2000-2003). Cost of Smoking

8. Health Canada (2009). Smoking and Your Body- Health Effects of Smoking

9. Health Canada (2008). Smoking and Your Body- Health Effects of Smoking

10. Health Canada (2008). Smoking Cessation in the Workplace- A Guide to Helping your Employees Quit


References

11. Health Canada (2008). Second-hand Smoke.

12. Health Canada (2007). Smoking Diseases. Health Effects of Smoking

13. Health Canada (2007). Towards a Healthier Workplace: A Guidebook on Tobacco Control Policies.

14. Health Canada (2007). Rewards of Quitting

15. Moskowitz, J.M., Lin, Z. and Hudes, E.S (2000). The impact of workplace smoking ordinances in California on smoking cessation. American Journal of Public Health

16. New Zealand Ministry of Health (2007). New Zealand Smoking Cessation Guidelines.

17. Pelletier B, Boles M, Lynch W. Change in health risks and work productivity over time. J. Occup Environ Med. 2004; 46 (7): 746-754.

18. Rehm, J. et al. (2006). The cost of substance abuse in Canada, 2002. Canadian Centre on Substance Abuse”

19. World Health Organization (2003). An international Treaty for Tobacco Control.


A Comprehensive Approach to Smoking Cessation in the Workplace Start Living Healthier.

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