Butting out for good

Although the proportion of people who smoke is considerably lower than it was a generation ago, more than 16 per cent of Canadians are still smokers and the majority smoke daily, according to a 2012 Health Canada survey.

Prevalence is higher among males (18.4 per cent) than females (13.9 per cent) and men tend to smoke more cigarettes per day. People 25 to 34 years old — prime working age — have the highest prevalence, found the government.

The good news is many smokers want to quit. But before investing time and resources in a workplace smoking-cessation program, organizations need to understand the practices that will have the biggest impact.

Staggering costs

On a national scale, smoking has enormous costs for business with losses estimated at $11.4 billion in 2010 alone. The average annual employer cost for a daily smoker added up to $4,256 in 2012 — up from $3,396 in 2005, according to a 2013 report from the Conference Board of Canada.

Part of the expense comes from smoking-related absenteeism. Since smokers are more prone to chronic conditions, infections and other illnesses, they tend to average two more sick days per year than those who have never smoked. In 2012, each daily smoker and recent quitter was estimated to cost employers $414, according to the report.

Smoking also has an impact on short- and long-term disability. Daily smokers and recent quitters are 2.3 times more likely to be off work for at least three months per year due to a chronic health condition. But the risk of disability falls once a former daily smoker quits — after 10 years smoke-free, the risk is similar to that of someone who has never smoked, according to the Conference Board.

When lost productivity and presenteeism are included in the tally, the impact is significantly higher. Unsanctioned smoking breaks have been shown to take up to one hour of an employee’s time throughout the day, resulting in a $3,842 annual loss per full- time employee.

York region supports workers

The Regional Municipality of York in Ontario is one organization that recognizes the importance of supporting employees in becoming smoke-free. Employees can take part in an annual smoking-cessation program to receive education and guidance, including coping strategies, goal-setting and ongoing support.

During the past six years, responses from program participants have been positive, says Jim Davidson, commissioner of corporate services for York Region. The organization also recognizes the financial benefit of offering a smoking-cessation program — it calculated a cost avoidance of $193,386 over five years, based on 2007-12 statistics.

Butting out isn’t easy and ongoing support is critical for success. Smokers need to understand it usually takes a few tries to quit and, while frustrating to try and fail, each attempt takes them closer to their goal. Evidence shows the majority of Canadians who have ever smoked have successfully quit — the quit rate reached 63 per cent in 2012, according to Health Canada.

By implementing a smoking-cessation program, the percentage of smokers in an organization would fall by 35 per cent, according to the Conference Board of Canada. York Region’s smoking-cessation program participants self-reported quit rates as high as 50 per cent, said Davidson.

Key strategies

Successful cessation programs share several key strategies:

•Begin with a health-risk assessment (HRA) to understand the organization’s smoking risk.

•Co-ordinate lifestyle change programs with benefits such as coverage of smoking-cessation medications.

•Align smoking cessation with broader health and wellness strategies in the workplace.

•Measure and evaluate programs.

•Establish a strong policy about a smoke-free work environment to discourage smoking during work time.

•Gain support from senior leadership.

•Engage employees, through targeted and regular communications, in the availability and accessibility of support programs.

•Consider hiring external organizations that have expertise in evidence-based cessation programs.

Fewer than one-half of organizations offer an HRA to understand the risk, according to the Conference Board, but it is essential to evaluate the number of smokers and their readiness to change.

Once employees’ attitudes toward smoking are uncovered, education and awareness can help get smokers ready to participate in a cessation program. Smokers need to know how tobacco usage affects their bodies and increases the risks for cancer, lung disease and cardiovascular disease. Incorporating testimonials from smokers who have successfully quit can drive the message home and demonstrate that quitting is not only possible but it also feels good.

When it comes to promoting behaviour change, a multifaceted approach that includes group and individual support works best. Over the years, developing technology has opened up a range of options for reaching the widest possible audience.

York Region, for example, added an innovative webinar format to meet the diverse working locations of employees. Online platforms provide convenience and allow for instant reporting and results. Everything from mobile applications to interactive webinars and email reminders can be integrated for a seamless approach.

Whether cessation programs are held face-to-face or online, various experts can discuss topics such as the pros and cons of different drug therapies, smokers’ nutritional needs and alternatives to pharmaceutical aids. Smokers are encouraged to discuss personal triggers, learn positive coping strategies, recognize signs of nicotine withdrawal and set individual goals that are achievable.

Just as ongoing support from family and friends helps keep someone on target, the program should include followup phone calls and emails to ensure participants have everything they need to keep to their goal.