May 26, 2022

Smoking Is Still the #1 Preventable Cause of Death and Disease—Here’s What Employers Can Do About It

One of a company’s most important assets is its employees. Companies invest a significant amount of time and money (in excess of $4,400) to recruit, train, develop, and retain each team member. This is on top of wages, benefits, and other perks. How can employers protect this investment? One way is by addressing the single preventable cause of death and disability—smoking and tobacco use. 

Smoking and Tobacco Use Are Still Pervasive  

Smoking rates have declined significantly over the past 50 to 60 years, yet smoking remains the top preventable cause of death and disease both in the U.S. and worldwide. Cigarette smoking causes at least 12 different cancers, cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes and diabetes care complications, inflammation and reduced immune function, reduced fertility, and birth complications. It’s also harmful for people who have diagnosed medical conditions (more on that below).

Some of the Hard Facts About Smoking and Tobacco:

  • All forms of tobacco—chew, dip, cigars, cigarettes, and so forth—are harmful.
  • There is no safe level of smoking, tobacco use, or exposure to tobacco.
  • 47 million adults in the U.S. (19%) use tobacco products.
  • 16 million Americans suffer from a disease caused by smoking and tobacco-related use.
  • Approximately 480,000 deaths due to smoking or tobacco-related use occur each year.
  • Another 50,000 people die due to secondhand smoke.
  • In the U.S., the proportion of healthcare expenditure attributable to smoking ranges between 6% and 18% across different states.

… and This Can Greatly Impact Employers

Smoking and tobacco use lead to significant cost and productivity loss. The annual cost of a smoking employee or family member to employers is estimated to be $5,800 higher than a non-smoking employee or family member. This includes $2,000 in excess healthcare costs and over $3,500 associated with lost productivity related to more sick days and smoking breaks.

In addition, smoking can lead to increased risk of occupational health hazards and may make employees more vulnerable to exposure to gasses, fumes, dust, and particles in the workplace. Allowing smoking at worksites or in workplace vehicles can increase the risk of fires and injuries and result in increased insurance costs (up to 30%). 

Smoking Disparities and Other Complications Employers Should Know

Tobacco use disproportionately affects many marginalized populations—including people in low-income communities, racial and ethnic minorities, LGBTQ+ individuals, and those who struggle with mental illness. For example:

  • While Black people smoke at a similar rate compared to white people, they are more likely to die from tobacco-related diseases. 
  • American Indians and Alaska Natives smoke at higher rates than all other racial/ethnic groups. 
  • Many smokers have mental health concerns.
  • Rates of smoking are significantly higher among LGBTQ+ adults (25.1%) than among adults who are heterosexual/straight (18.8%). 
  • Many of these disparities exist because of how the tobacco industry has aggressively marketed to these different groups. 

Additionally, as mentioned above, smoking can complicate chronic health conditions. Smoking is linked to increased pain/pain severity, reduced fertility and poorer pregnancy outcomes, poorer outcomes for individuals with cardiovascular disease or history of stroke, irreversible loss of lung capacity among individuals with COPD, and impaired insulin production and sugar management among individuals with diabetes. So, if you are investing in addressing chronic conditions among your employees (which many employers are), it’s important to address a major contributing factor—smoking and tobacco use—as well.  

What Employers Can Do About Smoking and Tobacco Use Among Their Workforce

Just like other addictions and chronic diseases, smoking requires treatment. Helping employees and their families out of genuine concern rather than financial reasons will go a long way in establishing trust. Here are some steps employers can take to help their people put an end to smoking and tobacco use once and for all. 

1. Start by fostering a culture of health and wellbeing and make sure to treat any employees who smoke or use tobacco with dignity and compassion.

2. Have clear and specific smoke and tobacco-free workplace policies. Here is an example.

3. Inspire and motivate your employees. They’re more likely to quit smoking when they feel quitting is encouraged and supported by leadership. 

4. Offer evidence-based cessation resources—coaching, apps, cessation medications—that are covered by insurance and/or the employer. When employers sponsor offerings, they can build programs that meet the unique needs of their workforce and more effectively promote through existing channels.

5. Make employees aware of resources available to them (like the ones listed below) and how to access them.

A connected navigation system like Castlight, which leverages data-rich personalization capabilities to ensure the right people get the right care, can help identify the employees and family members who would benefit from cessation resources

6. Promote cessation and associated resources often and through various communication channels. This is also where a connected navigation partner can be helpful, as it can push tailored messages to those who need to see them most, in the way that they prefer to communicate, whether that’s by chat, email, or phone.

7. Leverage the Great American Smokeout (GASO), which occurs on the third Thursday of November each year. Led by the American Cancer Society (ACS), GASO is a great opportunity to inspire and encourage employees who want to quit smoking, as thousands of people around the country use this as a jumping off point to quit each year. The ACS provides helpful tools and materials for GASO, too.

This post was written by Sue Zbikowski, chief science officer at 2Morrow.

About the Author
Dr. Sue Zbikowski is a behavioral scientist and entrepreneur. She’s an expert in designing and evaluating behavioral interventions to prevent disease onset and progression by addressing tobacco use, unhealthy eating, sedentary lifestyles, and unmanaged stress and chronic health conditions. She has authored or co-authored over 75 peer-reviewed publications and held various research leadership roles in the health and wellness industry, working for insurers and service providers.

About 2Morrow
2Morrow, one of Castlight’s Ecosystem partners, provides digital coaching for tobacco cessation, chronic pain management, weight management, and stress programs. By using an innovative behavioral approach called Acceptance and Commitment Therapy (ACT), participants learn strategies that are effective when dealing with unhelpful thoughts, feelings, and urges that get in the way of long-term success. The personalized experience includes short lessons, advanced messaging protocols, customized tips, and access to a live coach for up to 12 months.

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