How Wisconsin’s smoke-free law can help your company reduce costs, increase

productivity and improve health

Brian D. Harrison, MD

Is your company culture finally ready to rise from the ashes?

Complying with the law is simplebut don’t stop there!

• Add language to HR Policies

• Place signs

• Inform all employees

• Give supervisors guidelines for – Policy implementation – Conflict resolution– Referral

DON’T THINK PROBLEM!

THINK OPPORTUNITY!

Here’s the burden your organization has borne:

• Excess medical costs– Employees

• Who smoke• Who breath ETS

– Dependents• Who smoke• Who breath ETS

And you’ve been paying for:

• Productivity loss– Absence– Presenteeism

• Damage to facilities– Smoke– Fire risk

Cost of smoking to employer

• $3,391 per smoker per year total (CDC, MMWR

2002;51(14):300-303)

• Average PMPM health insurance cost (ACS,

2004)

– Smoker $1,145

– Nonsmoker $762

Tobacco-related excess medical costs

adding to the claims you pay

• Excess equals 10-25% of annual claims depending on your prevalence (Source: Javitz et al, "Financial burden of tobacco Use: an employer's perspective", Clinics in Occ & Env Med, 2006, 5(1) 9-21)

Tobacco-related excess absence costs

Adding to your cost of doing business

• Estimate three days excess absence per tobacco user

• To monetize, multiply the total excess by the average daily wage of your company

Tobacco related lost productive time while at work

Wasted wages• Smoking rituals: 1% of wages paid to the

percent who smoke. Estimate as total employee wages x 0.01 x smoking prevalence

• Presenteeism: 2.5% of wages paid to the percent who smoke. Estimate as total employee wages x 0.025 x smoking prevalence

• Together, 3.5% of wages of smokers

“Our corporate tobacco burden” By typical 1,000 employee work organization

• Prevalence: 20% of employees – 200 employees in our 1000 person workforce

• Excess medical costs: 15% of total – $450,000 of our annual $3 million health plan cost

• Excess absence costs: 3 extra days per smoker year– 3 days x $120/day average wage x 200 smokers = $72,000

• Excess lost productive time from rituals (1%) and presenteeism (2.5%) of the wages paid to smokers (3.5% total):– $28,800 ave. annual wage x 200 smokers x 3.5% = $201,600

• TOTAL = $723,600 PER YEAR

Now, the opportunity:benefits of smoke-free workplaces

• Employer wins with:– Cigarette consumption dropping 29%!

15% of smokers quit- the rest smoke 12% less (Glantz, 2004)

– Reduced impact of ETS on non-smokers– Lower medical costs- higher productivity as

smokers quit or smoke less– Maintenance costs decline, fire risk decreases

Benefits of smoke-free workplaces

• Employee wins with:– Clear, consistent policy– Safe, healthy environment– Accommodation of ETS-sensitive health

problems– Support for smokers who are trying to quit

Smoke-free workplace meets the needs of different types of people

• Contemplative smokers: supportive workplace

• Pre-contemplative smokers: motivation• Former smokers: relapse prevention• Nonsmokers: ETS protection

Why hadn’t it happened already?

• Employees have wanted it – 90% of nonsmokers– 40% of smokers (about the same number as will

make a quit attempt within the year)

• Unions usually agree or are neutral• Customers have looked for it• But the culture wasn’t ready for it

Now We Have aSMOKE FREE WORKPLACE LAW

You NeedTobacco Free Company Culture

Incorrect corporate culture regarding tobacco use

• It’s a personal right, an individual choice• It’s cool and sophisticated and shows independent

thinking• “All things in moderation.” The best of both worlds is to

smoke now and then• It’s a normal part of growing up and is a rite of passage • Tobacco helps socializing, recreation, work breaks and

enjoying life in general• Tobacco is part of some people’s identity• Taxes paid by tobacco users support society

Reality-based corporate culture

• Every member of this organization is an important and valuable human being; there are no disposable people

• Ours is a healthy work organization, committed to the safety, health and well-being of each of us individually and all of us together

• Tobacco use is an unhealthy addiction, promoted by those who stand to gain financially from it

• Every tobacco user in our organization is a valued and honored member, whom we all support—We will assist them when and if they choose to free themselves from tobacco

Reality-based corporate culture continued…

• Every ex-tobacco user in our organization is a Tobacco Free Hero, and an essential mentor and role model for others

• No one wants their children to become tobacco users; the need to be at work cannot be allowed to subtract from that obligation

But, the smoke-free law won’t fix:

• Smoking at entrances

• Smoking underneath company sign

• Smoking in cars in company parking lot

• Smokeless and spit tobacco use– On company grounds– In company vehicles– Indoors

• Electronic cigarettes

The smoke-free workplace law may not help:

• Tobacco-using employees who cannot stop or who relapse

• Non-smoking employees exposed to ETS at home from family members who smoke

• Family members who cannot quit• Non-smoking family members exposed to ETS at home

from employee who still smokes • Children who remain at risk for:

– ETS related health effects– Initiation of tobacco use

Prepare to be confronted by users of the electronic cigarette

So why ban e-cigarettes?

Not intended for use in smoking cessation or for any Therapeutic

use

Sample tobacco policy

"Because the tobacco-free policy is intended to promote our culture of health and safety, non-therapeutic nicotine delivery devices and products are not allowed on the premises. Only nicotine products that have FDA approval for treatment of tobacco addiction may be used."

Fewer people still smoke, but those who do are more likely to be heavy smokers

Will you be paying me later? Corporate tobacco targets your future employees!

• 80% of adult smokers start before they enter the workforce• Every day, 4,000 children under 18 try their first cigarette

– Half will become daily smokers (2,000)– Half of them won’t be able to quit (1,000)– Half of those will eventually develop a chronic smoking related

illness (500)– Employer-purchased health care will pay for most of the cost of that

illness (64.1%, US Census 2001)

What are your kids watching in movies?

• Tobacco use occurs frequently, but it takes up little screen time– Removing it would affect only 5% of the

movie

• Cigarette brands appear often– Increasingly endorsed by actors– The most highly advertised brands account

for most brand appearances (advertising motive)

Effect of Smoking in Movies Greatest in Children of Nonsmoking Parents

0%

2%

4%

6%

8%

10%

12%

14%

16%

0-531 532-960 961-1664 1665-5308

Number of Smoking I ncidents Kids Saw in 600 Popular Movies

Kid

s W

ho

Sta

rted

Sm

okin

g Nonsmoking Parents

Smoking Parents

The problem

• Smoking in the movies can more than triple the rate of smoking among adolescents

• Responsible for 52% of starters– After controlling for parent and sibling smoking, age,

gender, etc.– Stronger effect than cigarette advertising

• 1,070 kids start a day as a result of smoking in movies– 340 will die prematurely as a result.

Medical savings in < 1 year after tobacco cessation

– TAKE all maternal and newborn costs (to 6 months) – TIMES estimated smoking prevalence (such as

20%)– TIMES proportion reduced by smoking cessation

which is 21%– This is the potential savings, or “opportunity” in the

first year

Medical savings in 2-10 years of tobacco cessation

• TAKE total health care costs– TIMES tobacco-related proportion, which is:

• 10% if prevalence is low (say, less than 15% of employees) OR

• 10-25% if prevalence is high (say, 15-30%)– Because this takes about 10 years to be abolished,

figure about 10% decline per year• This is the potential annual savings, or

“opportunity”

Absenteeism savings after tobacco cessation

• Modifiable in 1-2 ½ years:– 25% of excess is reduced

• Modifiable in 2 ½ - 5 years:– 75% of excess has been reduced

• In either case, reduction of excess absence happens more rapidly in women than men

• This is the potential annual savings, or “opportunity”

Productivity Savings After Tobacco Cessation

• Time lost due to rituals: modifiable immediately after tobacco cessation

• Time lost due to presenteeism: improves at same rate as absenteeism (gradually over 5 years)

This won’t happen if you have:

• A company culture of tobacco acceptance

• A company culture that doesn’t tell employees you value them and their families

Affinity Occupational Health can help

• For more information on setting up a tobacco-free environment at your company, contact Affinity Occupational Health, 1-800-541-0351