The following sample Questions and Answers have been put together to guide you in your educational drive and supporting actions. You may also wish to print some in any in-house communication leaflets, flyers or newsletters.
Q:
Is it possible to save money by restricting smoking in the workplace?A:
Yes, but obtaining data on cost savings associated with workplace smoking control restrictions is difficult. Most economic studies examine the excess costs borne by companies as a result of having smokers on their payrolls. Estimates of the excess annual cost per smoking employee vary by an order of magnitude, but even conservative estimates are substantial.Q:
Are employers motivated primarily by costs in implementation policies ?A:
No. The law now makes provision for designated smoking areas in all public places, including the workplace. Employer surveys show that most workplace policies are implemented largely for reasons unrelated to cost. To protect the health of employees and ensure a safe working environment, as a reaction to non-smoking employees' demands for a smoke-free working environment, or a fear of possible legal liability for illnesses caused by exposure to environmental tobacco smoke in the workplace. Workplace smoking restrictions are an emerging trend since the 1980s and are becoming more wide spread because of the knowledge that the health of non-smokers is endangered by the smoke of others. The vast majority of people prefer to breathe clean air and are in support of smoking restrictions. Failure to act is likely to become the problemQ:
What are other economic motivations for employers to implement workplace smoking policies ?A:
Smoking policies of past decades focused on preventing fires or explosions around flammable materials and protecting machinery and products rather than protecting employee health. Similarly, employers with office smoking policies today realise cost savings because computer equipment, furniture, carpets and other furnishings last longer in a smoke-free environment with less maintenance.Q:
What is the effect of smoking restrictions on labour productivity ?A:
Some people argue that workplace policies can lower productivity because of excessive employee smoking breaks. However, to the extent that these policies tend to aid many employees in successfully quitting, it is likely that labour productivity increases through reductions in absenteeism and turnover and through increased productivity of these workers. That's because smokers are absent from work 50% more often than non-smokers, have twice as many on the job accidents, and are 50% more likely to be hospitalised than workers who do not smoke. Furthermore, non-smokers formerly bothered by co-workers' smoke may also be happier, healthier and more productive.Employers who provide smoking areas rarely find it is abused. It is after all a privilege for the smoker and not a right.
Q:
Can’t a company just ban smoking without making a big deal about it?A:
Although this may work for some companies, most organizations prefer a more sensitive approach to this issue. Surveys to document employee reactions, committees to develop policy recommendations, and employee-management meetings to discuss policy alternatives are just three options that have proven successful for business implementing a policy. Smoking policies, like any management decision affecting employees, require careful research and planning. Provided policy implementation has a firm basis of consultation and communicative education and support, there tends to be acceptance of the change.Q:
What are the components of a successful policy?A:
There are five progressive steps that a company should take to assure itself a successful smoking control policy:
- Cooperation begins with a management review in which a presentation is made defining the issue and the decision for which management is responsible. The management team then selects a program coordinator, a policy development team, and the work for which the team will be responsible.
- The first task of the policy development team is to complete a situation analysis, or internal information gathering process. This includes surveys and/or reviews of employees, labour relations and contacts, facilities, extent of personnel policies, and so on.
- Once the relevant facts are gathered, strategic planning begins, resulting in a written policy. The planning should include consideration of such important factors as policy enforcement, cessation assistance, smoking breaks, and in-house communications.
- The fourth step of the process is actual implementation. The company announces the policy, maximizes employee communications, holds special events, puts cessation programs in place, makes any physical changes to the work site that may be necessary, and begins monitoring the policy.
- The final stage, evaluation, allows the company to measure the result of the policy and its implementation.
Although far from inclusive, this list conveys the variety of decisions that need to be addressed. It is important to emphasize that halfway measures seldom work and are frequently far more difficult than substantive policies, both in terms of enforcement and execution. Non-smokers will need to be considerate and maintain an attitude of support.
Q:
With a total ban, couldn’t there be a serious problem with employee withdrawal symptoms?A:
Absolutely, nicotine is an extremely addictive drug. It is always recommended that a company provide a comprehensive cessation program to employees, sponsored either partially or totally by the company. There are, again, a number of viable options here, any of which can affect the policy’s success.* A factor often overlooked is that non-smokers need to be educated as well. It is important that they understand the tremendous adjustments smokers will be making, and that they need to maintain an attitude of support, not disrespect.
Q:
What is Passive Smoking?A:
Passive smoking, second-hand smoking, involuntary smoking or exposure to environmental tobacco smoke (ETS) all refer to the phenomena of breathing other people's smoke. It is the most common and harmful form of indoor air pollution. ETS is a complex contribution of over 4 000 chemicals in the form of particles and gasses including 43 known carcinogens. ETS is a combination of exhaled mainstream smoke and sidestream smoke:
- Mainstream smoke is first inhaled, then exhaled by the smoker
- Sidestream smoke goes directly into the air from the burning end of the cigarette between puffs
Q:
Should one be concerned about breathing in someone else's smoke:A:
Yes. There is substantial scientific evidence that second-hand smoke is a serious health threat. Non-smokers who breathe second-hand smoke suffer many of the diseases of active smoking. Heart disease mortality as well as lung and nasal sinus cancers have been causally associated with second-hand smoke exposure. Second-hand smoke also causes a wide variety of adverse health effects in children including bronchitis and pneumonia, exacerbation of asthma, middle ear infections, and "glue ear", which is the most common cause of deafness in children. Exposure of non-smoking women to second-hand smoke during pregnancy causes reduction in fetal growth, and there is also evidence that postnatal exposure of infants to second-hand smoke contribute to the risk of sudden infant death syndrome (SIDS).Tobacco smoke is also an important source of indoor air pollution, causing such immediate effects as eye and nasal irritation, sore throat, dizziness, nausea, cough and respiratory problems.
The higher the level of exposure to ETS the greater the risk of contracting these illnesses. It is estimated that 1 in 4 deaths from lung cancer amongst non-smokers is due to passive smoking.
A non-smoking office worker sharing a room with a smoker could inhale the equivalent of up to 5 cigarettes a day in smoke particles, including many carcinogens.
Q:
Can ventilation prevent passive smoking?A:
Ventilation systems and air conditioning are not adequate to remove all ETS.Air conditioners tend to redistribute smoke-filled air. They do not solve the workplace-smoking problem. It is usually not feasible to set up separately air conditioned areas. The total removal of tobacco smoke through ventilation is technically and economically impractical, so although good ventilation may reduce the problem, it will not solve it. The most effective approach to passive smoking is to control it through a smoke-free workplace policy.
Q:
Is smoking addictive ?A:
Yes. Nicotine is as addictive as cocaine or heroin. Cigarette smokers and drug users both develop a strong dependency and, when quitting, experience withdrawal symptoms. For smokers, these commonly include difficulty concentrating, irritability, mild headaches, and occasional insomnia.Q:
How should cessation programmes deal with the addiction process ?A:
Smoking begins as a behavioural habit that develops quickly into physical dependency. Cessation programmes must recognise both
these aspects: the psychological and the chemical.Q:
What does this mean for the company wanting to help its employees kick their cigarette habits?A:
It means quite clearly that companies should take the nicotine addiction problem seriously and be ready to help smokers overcome it. "Let smokers fend for themselves" is not an adequate response on the part of management. It is important for smokers to feel that they will have help in coping with the change. You may want to offer support and assistance before implementation begins, but it is essential to offer it once the policy is being phased in, and to continue offering it when the policy is fully introduced.Q:
What techniques will an effective cessation programme use ?A:
Programmes consisting of several treatment components or approaches are proven to be the most successful. In general, these include the following:
- Self-Help Materials. Books, audio tapes and video tapes, leaflets, correspondence courses, and other aids (e.g. filters) help smokers quit using strategies that most appeal to them. These materials also reinforce the counseling suggestion given to smokers in structured programmes.
- Behavioural Interventions. Smoking is a behaviour that people have incorporated into their lives. Behavioural methods help smokers replace old habits and patterns with new ones, develop coping skills for dealing with temptations, and manage self control. These approaches frequently emphasize group work.
- Physician Monitoring. Physicians can play a critical role in smoking cessation programmes by counseling patients about smoking in addition to keeping in touch with them, continuing to issue advice, and following up on their progress.
- Pharmacological Aids. Nicotine substitutes in the form of gum prescribed by a physician help the smoker to fight the physical addiction separately from the psychological one. Other substances are available by prescription or over the counter. Importantly nicotine gum has been shown to be effective only when used in conjunction with a stop-smoking programme, under the care of a health professional.
Q:
With so many smoking cessation programmes on the market, how does one choose?A:
Individuals need to examine their smoking habits and select the programme best suited to their specific needs. Similarly, corporate smoking cessation programmes should account for the great diversity of a smoking population. To maximize cessation success in a corporate situation, it is recommended that the occupational health staff guide employees to programmes that offer a variety of strategies and provide training and follow-up.Q:
How much financial responsibility should the company take for its cessation programme?A:
Healthy employees can save the company money in the long run. Offering the programme on company premises and on company time at a discount or free, are demonstrations of management's concern for its employees. These choices also ensure maximum participation in the programme and create a valuable support network among employees.It must be mentioned though that quit courses are most successful if people want to be there, rather than because they have been directed to attend, because it is free, or gives them time away from work.
You may wish to offer:
- Quit courses in the workplace, if there is sufficient demand.
- Paid time-off to attend a community based quit course, or other approved treatment, on a once only basis.
- Part payment or refund of course fees or other approved treatments upon completion. It is important for employees attending such courses to contribute some or all of their time or money, as personal commitment is essential for success.
Do-it-yourself, self-help kits are cost effective alternatives to the organised course for smokers who don’t need the extra support of a group. Ensure that smokers wishing to quit have access to a range of free or inexpensive self-help materials.
Incentives may help quit programs to succeed. Incentives could include:
- Time or financial commitment to quit courses.
- Pot plants or fresh flowers for employers who have quit for three months.
- A congratulatory certificate for quitters.
- Competitions with motivational prices.
- Matching the sum of money donated to a charity for those who wish to put their savings gained from stopping smoking towards a worthy cause (e.g. fighting cancer or heart disease).
- Refunding remaining contribution to a Quit course if the employee is still not smoking after 12 months
Q:
Is it better to develop a company smoking cessation programme internally or to hire professionals?A:
The company's decision depends on a variety of factors such as corporate resources, staff expertise, and the number of smoking employees. The company can provide a list of community cessation programmes that are approved by the employer or company-run programmes through which on-site programmes may be led by company staff of company trained volunteers. Another choice is to hire smoking cessation vendors that provide either on or off-site programmes. These vendors may be either non-profit or commercial, local or national organisations. Participation in cessation programmes will be improved if they are offered at the worksite and at times that are convenient for employees.Q:
What are the key variables in programme selection?A:
Once a company establishes the criteria for a programme (e.g. on-site, on company time, available to employees and spouses), it can determine which programme responds to these needs. Perhaps the most critical consideration is a reference check on the programme. Is the group reputable? With what parent organisation is it affiliated? How long has it been in the cessation business? What does its past clients (satisfied and dissatisfied) say about the programme? For companies that are able to do an extensive analysis of their options, some questions to consider are:Training: Do the cessation programme leaders receive adequate, standardised and ongoing training? How long is the training? Does the staff include former smokers?
Content: What is the research base of the programme? What education materials does it offer its participants? What is its mode of treatment? How long does the programme last? Is the programme flexible? Does it offer a variety of strategies?
Program Results: What is the programme's quit rate? How was this rate determined? What is its definition of success?
Guarantees: Can an employee repeat the programme at reduced cost or no charge?
Location: Can programmes be offered on-site, off-site or both?
Time: Can programmes be offered at required times?
Discounts: Are group rates available?
Replication: Can the programme be repeated in all the company's facilities?
Promotion Assistance: Will the organisation help promote its programme within the company?
Q:
Some cessation programmes promise such phenomenal results. How can one honestly compare relative success rates?A:
Because smoking cessation programmes are evaluated in so many different ways, with the lack of a standard by which all programmes are judged, comparison of results can be a difficult process. Different "success" rates can be due, for example, to the design of the evaluation. Does it measure all people who sign up for the programme, all who attend a first session, all who complete, or only those who respond to the evaluation survey? Generally, the further along evaluation begins, the higher the reported success rate will appear. Here are two practical steps that companies can take when weighing programme options.First, realise that the range of typical quit rates is 20 - 40 % at 1 year follow-up. Be wary of vendors claiming quit rates that far exceed this range.
Second, check vendor's references and ask for referrals from other companies that have had successful cessation programmes. Referrals can also come from other organisations like the Cancer Association of SA, the National Council Against Smoking and the Heart Foundation of SA.
- Carbon monoxide, up to 15 times greater.
- Nicotine, up to 21 times greater.
- Ammonia, up to 170 times greater.
- Some carcinogens up to 100 times greater.
For more information and help to quit phone:
Department of Health - Health Promotion Directorate: (012) 312 0165/6Cancer Association of SA Toll Free 0800 22 66 22
Tobacco or Health Info Line (011) 720 3145
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