Magazine article The Journal of Employee Assistance

Employer Initiatives to Stop Smoking: As More Employers Take Aggressive Steps to Reduce Health Care Costs Arising from Employees' Tobacco Use, EAPs Can and Must Help Ensure the Process Goes Smoothly and Meets the Needs of All Parties Involved

Magazine article The Journal of Employee Assistance

Employer Initiatives to Stop Smoking: As More Employers Take Aggressive Steps to Reduce Health Care Costs Arising from Employees' Tobacco Use, EAPs Can and Must Help Ensure the Process Goes Smoothly and Meets the Needs of All Parties Involved

Article excerpt

John is a 48-year-old who has worked for 25 years in the auto assembly field. He has smoked a of cigarettes daily since his teens. He has tried multiple times to quit, but has never been able to maintain abstinence for more than a few weeks.

John recently became concerned about a swollen lymph node and had it checked by his doctor. A biopsy revealed squamous cell carcinoma, a form of cancer. He is facing radical neck dissection surgery, followed by radiation.

Stories similar to John's are unfolding for many aging baby boomers who are experiencing the health consequences of years of tobacco use. According to the U.S. Centers for Disease Control and Prevention (CDC), tobacco use is the leading cause of preventable death in the United States, responsible for one in every five deaths. (1) Tobacco kills more Americans each year than alcohol, cocaine, crack, heroin, homicide, suicide, car accidents, fire and AIDS combined. (2) On average, male smokers die 13.2 years prematurely, while female smokers die 14.5 years early. (3) More than 50 diseases have been linked to smoking, including cancers, heart disease and lung disease. (4)

The financial costs associated with tobacco use are equally staggering: Direct medical costs related to smoking in the United States total roughly $75 billion a year. (5) The CDC estimates that companies spend $3,856 per smoker per year in direct medical expenses and lost productivity resulting from premature death for people with smoking-related diseases. (6)

Given the adverse social and medical consequences of tobacco use, why don't more smokers quit? Because nicotine, the drug in tobacco that causes addiction, (7) is at least as addictive as heroin or cocaine. If a regular smoker abruptly stops using tobacco or greatly reduces the amount smoked, withdrawal symptoms such as depression, anger, irritability, and gastrointestinal discomfort may occur. (8) The difficulty of dealing with these symptoms lead many would be quitters to resume smoking.

It's no wonder, then, that nearly 21 percent of adult Americans currently smoke (9) and that each year only about 3 to 5 percent of smokers quit for a year or longer or for good. (10) Quitting involves reducing the physical dependence on nicotine as well as making major behavior changes to help break the psychological reinforcement resulting from tobacco addiction. It takes most smokers several attempts to stop smoking permanently

HOW EMPLOYERS ARE RESPONDING

In spite of evidence that tobacco cessation programs can help reduce employers' costs and improve workers' health, a Deloitte & Touche survey found that just over half of employers offer smoking cessation programs, (11) while the National Business Group on Health reports that only 24 percent of employers cover medical costs associated with tobacco use treatment. (12) Recently, however, more employers have begun to realize they can no longer ignore the impact of smoking on their bottom line. Following are examples of how some employers are dealing with this issue:

Banning smoking on company property. A growing number of states are banning smoking in most workplaces. The potential advantages of such bans include improved morale among non-smokers, reduced liability from lawsuits by non-smokers (for exposure to second-hand smoke), better air quality, and lower building maintenance fees.

One manufacturing firm prohibits not only the use and possession of tobacco in company buildings but also the presence of "tobacco residuals-emitting persons." Under this ban, any employee, visitor, or customer who has used a tobacco product within two hours of entering a company facility is automatically turned away. (13)

Before implementing smoking bans, employers should offer resources for smokers who will be affected by the ban and revise their policies and benefits to recognize that permanent smoking cessation will often require ongoing support. …

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