Gearing Up For The Ban

Since the recent agreement by the Wisconsin legislature and Gov. Jim Doyle to ban smoking statewide in all workplaces – including bars and restaurants – on July 5, 2010, interest in workplace smoking cessation programs is likely to light up.

There’s an attractive business case for persuading workers to give up tobacco – lower health care costs, higher productivity, reduced absenteeism, according to Geraldine Hamm, lead wellness coordinator for Ingenuity First, a division of ThedaCare that offers wellness services to area employers.

Smoking costs employers an estimated $3,391 per smoker per year, which breaks down into $1,623 in direct medical expenditures and $1,768 in lost productivity, according to statistics provided by the University of Wisconsin Center for Tobacco Research and Intervention. In addition, businesses pay an average of $2,189 in workers’ compensation costs for smokers, compared with $176 for non-smokers.

Those costs are prompting many employers to take another look at the benefits of supporting smoking cessation. “In today’s economic climate, first and foremost on people’s mind is the dollar sign,” Hamm says.

Creating a strategy
Promoting smoking cessation is a long-term investment in employee health that begins when a company creates a clear policy on tobacco use, according to Michelle Lytle, worksite wellness director at Appleton Papers Inc.

Appleton Papers has stayed focused on smoking cessation since early 2002, when it restricted smoking to designated areas and notified employees that smoking would be banned from its campus in 2003.

Lytle says constant communication helped employees accept the change. At the time, 11 percent of employees smoked. “Instead of just saying, ‘Stop smoking,’ we said, ‘We will help you,’” Lytle says. Free assistance offered to employees included:

»Access to a nurse practitioner on-site for one year before and one year after the smoke-free deadline to provide one-on-one evaluations and prescriptions for medications such as nicotine patches and gum.

»On-site smoking cessation classes and programs such as hypnosis.

»Education and information about the impact of smoking and community resources, including fliers, posters, e-mails and newsletter articles.

As a result, smoking among employees dropped to 9 percent by 2005 and then to 4.4 percent in 2007, with another survey of the company’s 1,130 Appleton employees to be completed in 2009. In comparison, smoking rates remain at about 20 percent nationwide and in Wisconsin.

Businesses that fail to take a stand are ignoring clinical evidence that tobacco users have a higher incidence of health concerns that lead to higher health plan costs, says Larry Sobal, CEO of Appleton Cardiology Associates.

Equally important, smokers expose friends and family members to harm by way of secondhand smoke. CTRI statistics show that non-smokers exposed to secondhand smoke are 12 to 19 percent more likely to get lung cancer and increase their risk of having a heart attack by 25 to 36 percent.

Appleton Cardiology Associates encourages employees and their dependents to reduce their risks by tying employees’ share of health plan premiums to nicotine use and four other clinical measures.

“In our organization, a non-nicotine using employee pays $10 less per pay period for health insurance,” Sobal says. “Another credit of $10 is available if the employee has a non-smoking spouse who participates in the plan. These can provide a total savings of $520 per year. If they meet our other health metrics, employees can reduce their contribution to health insurance by over $1,000.”

While it’s too soon to produce data about the policy’s impact on employee health, Sobal says feedback shows employees and family members are already changing their habits.

Getting started
When employers create tobacco cessation programs, Hamm says they need to plan for an ongoing effort because it typically takes multiple attempts to beat nicotine addiction. Only 5 percent of smokers who attempt to quit “cold turkey” are successful on their first try. The use of prescription medications boosts the success rate to 35 percent.

In Wisconsin, employers can refer tobacco users to free assistance offered by the Wisconsin Tobacco Quitline, which combines telephone sessions provided by trained counselors with free access to the first two weeks of nicotine replacement therapy.

Other steps suggested by smoking cessation leaders include:

»Ban smoking from the workplace “campus,” which means both the building and the surrounding property.

»Continually educate employees about the costs and health impact of smoking, as well as resources that can help them quit.

»Pay for medications that support smoking cessation, even when multiple attempts to quit are required.

»Reward non-smokers with financial incentives.

While the smoker must still make the decision to beat the addiction, Sobal says it’s time for employers to take a more active role. By combining commitment and resources, businesses can help convince workers there’s never been a better time to quit.