Post on 18-Dec-2015
A Comprehensive Approach to
Smoking Cessation in the Workplace
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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?
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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 bulletsto smoking cessation.
Access and evidence to support cessationcounselling were not available.
The effect of smoking on workplacehealth and productivity is currentlywell 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 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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PHYSICALPHYSICAL
BEHAVIOURALBEHAVIOURAL
EMOTIONALEMOTIONALPSYCHOLOGICALPSYCHOLOGICAL
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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
“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
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Impact on the Workplace:Smoking & Productivity
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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
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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$
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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)
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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
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Smoking & the Workplace… Totalling the Costs in Atlantic Canada
Annual Cost to Annual Cost to EmployersEmployers in in New BrunswickNew 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
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Smoking & the Workplace… Totalling the Costs in Atlantic Canada
Annual Cost to Annual Cost to EmployersEmployers in in NewfoundlandNewfoundland
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
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Smoking & the Workplace… Totalling the Costs in Atlantic Canada
Annual Cost to Annual Cost to EmployersEmployers in in Prince Edward IslandPrince Edward Island
Increased absenteeism N/A
On-the-job productivity losses $ 43.0 Million
Increased life insurance premiums N/A
Smoking area costs N/A
TOTAL N/A
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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
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Smoking: Why Should Employers HelpEmployees Stop Smoking?
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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
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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
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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
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What Supports Can Employers Provide - What is Ideal?
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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
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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.
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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
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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
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A Comprehensive ApproachConsiderations
There should be no cost to the employee to participate, and medications/nicotine replacement therapy should be subsidized
Cost
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A Comprehensive ApproachConsiderations
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
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A Comprehensive ApproachConsiderations
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
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A Comprehensive ApproachConsiderations
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
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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 representmanagement, employees, 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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Thank You
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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
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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.
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