A Comprehensive Approach to
Smoking Cessation
in the Workplace
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Smoking and Human Health
Smoking – An Addiction to Nicotine
Why Consider Stopping Smoking?
Why Should Unions Support Stop Smoking
Programs in the Workplace?
What Supports Can be Provided in the Workplace
and What is Ideal?
How Can Unions Support and Promote Stop
Smoking Programs in the Workplace?
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Background & Rationale
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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.
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Smoking and Human Health
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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!’
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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
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Smoking Rates by Occupation in Canada
40%
35%
30%
25%
20%
15%
10%
5%
0%
Trade,
Processing
Sales or service Administrative,
transportation or manufacturing or
financial or
equipment
utilities
clerical
operators
Professionals
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Smoking and Human Health
Tobacco is the only legally available consumer
product which kills people when used entirely
as intended.
World Health Organization
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Smoking – An Addiction to Nicotine
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Nicotine Withdrawal
8:00 am - Had a cigarette
10:00 am - Experiencing withdrawal
12:00 pm - Reaching peak withdrawal
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PHYSICAL
PSYCHOLOGICAL
EMOTIONAL
BEHAVIOURAL
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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
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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
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Smoking Cessation…
Myths and Misconceptions
“Stop smoking programs 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
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Why Should Union Members Consider
Stop Smoking Programs?
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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
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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
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Stop Smoking Support
Cost Savings
$80,000.00
$70,000.00
$60,000.00
Based on
1 pack per day,
$10 per pack
$50,000.00
$40,000.00
$30,000.00
$20,000.00
$10,000.00
$0.00
6 months
1 year
5 years
10 years
15 years
20 years
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Stop Smoking Support
Cost Savings
Half a year
of groceries
1 family trip
down south
146 DVDs
50’’ plasma
big screen
TV
With the money
saved after 1 year…
12 ipods
Half
semester of
tuition
122 tanks
of gas
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Why Should Unions Support Stop
Smoking Programs in the Workplace?
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Why Help?
Unions can be a champion in promoting and advocating for the health
of its members (smokers and non-smokers alike)
Stop smoking programs could be one of the most effective supports
Member smoking affects union contract negotiations as employers
seek to offset the costs associated with smoking
(e.g., sick days, insurance)
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Why Help?
Smoking Cessation is Challenging:
 Many union members face work stresses and use nicotine to cope
 Workplaces that permit smoking on site makes stopping smoking
especially difficult
 Some members hold multiple jobs, do shift work, or have transportation
challenges and therefore can only access stop smoking support when
held on-site, during multiple shifts or via telephone
 Second hand smoke can causes health risks for non-smoking members
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Impact on Members
Increased
Insurance
Premiums
Poor Health
Smoking
Union Member
Less
Disposable
Income
(used on
cigarettes)
Social Stigma
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What Supports can be Provided
in the Workplace and
What is Ideal?
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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
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Success
Without support, smoking cessation is
challenging for employees.
Only 2.5-5% of smokers
who attempt to quit
unaided will succeed
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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
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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
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A Comprehensive Approach
Considerations
Cost
There should be no cost to the
employee to participate, and
medications/nicotine replacement
therapy should be subsidized
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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.
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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
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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
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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
union management, union members, etc.
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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
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How Can Unions Support &
Promote Stop Smoking Programs
in the Workplace?
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Smoke Free
Worksites / Workplaces
Unions can lead in…
 Negotiating for a formal written no-smoking
policy if none exist at worksites
 Negotiating to strengthen an existing no-smoking policy
 Adopting resolutions in support of smoke-free workplace policies
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Health Benefits
Unions can lead in…
 Negotiating for comprehensive stop smoking
therapy in member health benefits
 Negotiating for improved coverage
 Subsidize nicotine replacement therapy
and cessation medication drug coverage
 Eliminating lifetime maximum coverage
 Improving access to counselling support:
 Group counselling
 One-on-one counselling
 Smokers Helpline
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Member Needs
Unions can lead in…
 Working with management
and other key stakeholders
to ensure the needs of
members are met
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Promotion
Unions can lead in…
 The promotion of the benefits
of the program to its members
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Summary
Areas in which unions can lead and support its members in stopping
smoking:
 Smoke-free worksites/workplaces
 Negotiating for comprehensive smoking cessation health benefits
 Understanding and advocating for the needs of members around stop
smoking support
 Promotion of stop smoking programs
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Thank You
Thank you to CDHA for their participation in
content development.
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References
1.
Canadian Cancer Society (2008). Effective Workplace Tobacco Cessation
Interventions
2.
Canadian Cancer Society (2008). Tobacco Statistics in Canada; Health Canada
(2007). Smoking Diseases. Health Effects of Smoking.
3.
Canadian Cancer Society (2008). Second Hand Smoke is Dangerous.
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.
Health Canada (2008). Smoking Cessation in the Workplace- A Guide to Helping
your Employees Quit
8.
Health Canada (2008). Second-hand Smoke.
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References
9.
Health Canada (2008). Smoking and Your Body- Health Effects of Smoking
10.
Health Canada (2007). Rewards of Quitting
11.
Health Canada (2007). Towards a Healthier Workplace: A Guidebook on Tobacco
Control Policies.
12.
Health Canada (2003). Canadian Tobacco Use Monitoring Survey. 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
13.
New Zealand Ministry of Health (2007). New Zealand Smoking Cessation
Guidelines.
14.
Rehm, J. et al. (2006). The cost of substance abuse in Canada, 2002. Canadian
Centre on Substance Abuse”
15.
World Health Organization (2003). An international Treaty for Tobacco Control.
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