Clearing the air - enforcing no smoking policies in the work place - includes related article - Special Report

HR Magazine, Feb, 1993 by Jeffrey S. Harris

There do not seem to be any hard data available on effects on dependents. Anecdotal and reimbursement-claims evidence indicates that spouses are quitting, especially in company-sponsored programs. Dependents of employees who quit are exposed to less smoke, lowering their health risks and the company's insurance costs.

Social support is known to be critical to sustained quitting. Thus an emphasis on dependents is warranted. CIBA-Geigy provides a particularly good example. Dr. Michael Quatrella, the corporate medical director, feels that opening smoking-cessation classes to families has had a supportive effect similar to Al Anon (the family support group associated with Alcoholics Anonymous). He feels that this explains the sharp drop in smoking prevalence in one year. A number of companies have observed significant difficulties if one spouse attempts to quit and the other continues to smoke.

Interesting highlights

Since this was a management rather than a scientific study, we placed more emphasis on the process of becoming smoke free than on survey research on results. Nevertheless, the comparisons are illuminating.

The companies that went smoke free first were in the health-care industry and in insurance (where the corporate culture might be expected to be supportive of healthy behavior), telecommunications (where there has traditionally been a strong emphasis on employee health), and banking.

Many employers hope that restrictions on smoking will induce some smokers to quit or at least reduce their consumption, thus improving health and reducing costs of health care. In one of the few studies examining the differences in health-care costs between smokers and nonsmokers, tobacco users had more hospital admissions per 1,000 (124 vs. 76), bed-days per 1,000 (800 vs. 381), a longer average length-of-stay (6.47 days vs. 5.03 days), higher insurance payments ($1,145 vs. $762), and higher outpatient payments ($122 vs. $75).(8)

Researchers evaluated the effects of the smoke-free policy at Johns Hopkins Medical Center by progressively tracking a group of employees. The policy effectively abolished observable smoking in cafeterias and lounges. Cigarette debris found in elevators and lounges dropped dramatically. The number of fires attributed to smoking decreased from an average of four per year to zero in the first year of policy implementation. Atmospheric nicotine, used as a proxy for ETS, fell by almost 99 percent in all areas except rest rooms, where the level fell by nearly 80 percent. Particulates decreased significantly at one year.(9)

In a Texas public assistance agency, offices could choose to ban or restrict smoking. In areas with bans, smoking prevalence dropped from 25.1 percent to 16.6 percent six months after the ban. In areas with restrictions only, there was no decrease in prevalence.(10) The changes were not statistically significant, however. This study did report a significant 75 percent drop in the number of cigarettes smoked per day. The number of cigarettes smoked decreased significantly at work only. Since the health effects of smoking are dose-related, illnesses should decline. In addition, the proportion of employees reportedly bothered by co-workers' smoke dropped from 21.8 percent to 3.8 percent. The authors suggest that a ban may be easier to enforce than restrictions.