A Comprehensive Approach to
Smoking Cessation
in the Workplace
Start Living Healthier
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?
Start Living Healthier
Background & Rationale
Start Living Healthier
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 bullets
to smoking cessation.
Access and evidence to support cessation
counselling were not available.
The effect of smoking on workplace
health and productivity is currently
well documented.
Start Living Healthier
Smoking and Human Health
Start Living Healthier
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!’
Start Living Healthier
Smoking and Human Health
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
Start Living Healthier
Smoking and Human Health
Tobacco is the only legally available consumer
product which kills people when used entirely
as intended.
World Health Organization
Start Living Healthier
Smoking – An Addiction to Nicotine
Start Living Healthier
Nicotine Withdrawal
8:00 am - Had a cigarette
10:00 am - Experiencing withdrawal
12:00 pm - Reaching peak withdrawal
Start Living Healthier
PHYSICAL
PSYCHOLOGICAL
EMOTIONAL
BEHAVIOURAL
Start Living Healthier
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
Start Living Healthier
Smoking Cessation…
Myths and Misconceptions
“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
Start Living Healthier
Smoking Cessation…
Myths and Misconceptions
“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
Start Living Healthier
Impact on the Workplace:
Smoking & Productivity
Start Living Healthier
What’s the Impact on the Workplace?
Employees smoking costs employers money!
Higher Insurance
Costs
Time Off Work
Employee
Smoking
Decreased
Productivity
Start Living Healthier
What Does This Mean for Your Company?
The Burden of Smoking
Enter number here
(double click)
# of employees at YOUR company =
Smoking Breaks
Time Off Due to Illness
Life Insurance
Health Insurance
Smoking Area
TOTAL after 1 year
TOTAL after 3 years
150
$
$
$
$
$
87,010.50
9,205.50
2,394.00
2,137.50
570.00
$
$
101,317.50
303,952.50
* based on a mean salary in Canada of $38,978 (2006)
Start Living Healthier
What Does This Mean for Your Company?
Return on Investment
Enter number here
(double click)
150
Enter Number of Employees at YOUR Company
Potential savings derived from projected quitters over 3 years
$
6,033.77
Projected smoking cessation treatment (SCT) expenditures
over the next 3 years
$
2,598.10
Potential net savings associated with this program over 3 years
$
3,435.68
For every dollar spent for SCT reimbursement,
the following SAVINGS is generated:
$
2.32
* based on a mean salary in Canada of $38,978 (2006)
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.
Start Living Healthier
Smoking & the Workplace
… Totalling the Costs in Atlantic Canada
Annual Cost to Employers in Nova 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
Start Living Healthier
Smoking & the Workplace
… Totalling the Costs in Atlantic Canada
Annual Cost to Employers in New Brunswick
Increased absenteeism
$ 18.2 Million
On-the-job productivity losses
$ 174.9 Million
Increased life insurance premiums
$ 7.2 Million
Smoking area costs
$ 8.0 Million
TOTAL
$ 208.3 Million
Start Living Healthier
Smoking & the Workplace
… Totalling the Costs in Atlantic Canada
Annual Cost to Employers in Newfoundland
Increased absenteeism
$ 11.9 Million
On-the-job productivity losses
$ 94.8 Million
Increased life insurance premiums
$ 4.5 Million
Smoking area costs
$ 5.1 Million
TOTAL
$ 116.3 Million
Start Living Healthier
Smoking & the Workplace
… Totalling the Costs in Atlantic Canada
Annual Cost to Employers in Prince Edward Island
Increased absenteeism
On-the-job productivity losses
N/A
$ 43.0 Million
Increased life insurance premiums
N/A
Smoking area costs
N/A
TOTAL
N/A
Start Living Healthier
Smoking & the Workplace
… Totalling the Costs (annually)
Smoking
Breaks
Time Off Due to
Illness
Life
Insurance
Health
Insurance
Smoking
Area
$3,053
$323
$84
$75
$20
TOTAL = $3,555 per Smoking Employee
Equal to an Average of 8.7% of Payroll
Start Living Healthier
Smoking:
Why Should Employers Help
Employees Stop Smoking?
Start Living Healthier
Blood
pressure &
pulse return to
normal
Risk of heart
attack begin to
decrease
20
8
24
48
Minutes
Hours
Hours
Hours
Oxygen levels
return to
normal
Sense of taste
& smell
improve
Start Living Healthier
Improvements
in lung
function and
circulation
2
Weeks
Risk of heart
disease is
reduced by
1/2
9
Months
Lungs improve
capacity to
clear & reduce
infection
1
Year
Risk of lung
cancer is
reduced by
1/2
5
Years
Risk of stroke
is reduced
10 15
Years
Years
Risk of heart
disease is similar
to a person who
never smoked
Start Living Healthier
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 and
cost efficient support employers can provide to improve
employee health
Start Living Healthier
What Supports Can Employers
Provide - What is Ideal?
Start Living Healthier
Range of Smoking Cessation
Programs/Supports
Comprehensive (greatest impact!)
 Offering programs, supports and activities at the workplace (on-site,
during work hours, etc.)
Facilitated
 Working with outside agencies to deliver
programs, supports and activities off-site
and providing self-help materials
Education & Information
 Provision of educational self-help materials
Start Living Healthier
Success
Without support, smoking cessation is
challenging for employees.
Only 2.5-5% of smokers
who attempt to quit
unaided will succeed
Start Living Healthier
Success
The provision of workplace support will empower employees to work
towards reaching their cessation goals.
NRT doubles
long-term success
Telephone counselling + one
session face-to-face
counselling increases success
Medication and intense
face-to-face counselling
increases success
Smoking cessation
medication triples
long-term success
Compared to no support,
face-to-face counselling
increases success
Telephone counselling +
medication increases
success
Start Living Healthier
Supporting Smoking Cessation
Smokers are 2-3 times more likely to succeed with support
than without
Stop smoking rates increase when a workplace
smoke free policy (restriction) is implemented
 Over 26% of the smokers who were
prohibited from smoking at work had
stopped smoking in the past 6 months,
compared to 19% without a
no smoking policy
Start Living Healthier
A Comprehensive Approach
Considerations
Cost
There should be no cost to the
employee to participate, and
medications/nicotine replacement
therapy should be subsidized
Start Living Healthier
A Comprehensive Approach
Considerations
Accessibility
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.
Start Living Healthier
A Comprehensive Approach
Considerations
Accessibility
Smokers Helpline – free, confidential
telephone support, tips, tools and advice
from trained ‘Quit Specialists’
 NS, NB, PEI - 1-877-513-5333
www.smokershelpline.ca
 NL - 1-800-363-5864
www.smokershelp.net
Start Living Healthier
A Comprehensive Approach
Considerations
Tailoring
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
Start Living Healthier
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 represent
management, employees, etc.
Start Living Healthier
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
Start Living Healthier
Thank You
Thank you to CDHA for their participation in
content development.
Start Living Healthier
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
Start Living Healthier
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.
Start Living Healthier