More than you might think.
Despite tobacco control efforts like warning labels, cigarette taxes, and smoke-free laws, nicotine addiction remains a stubborn public health problem in the United States. According to the Centers for Disease Control and Prevention, the tab for treating smoking-related illnesses comes to nearly $170 billion annually. When summed with other expenses like lost productivity, the cost to the economy climbs to more than $300 billion per year.
The figure is staggering, but to truly grasp the impact of tobacco use at the organizational level, it may be helpful to discard large numbers and drill down to specifics.
Researchers at The Ohio State University have found that the average smoker costs his or her employer approximately $6,000 per year in excess medical bills and lost productivity.
The health risks of tobacco use are well known. Smoking has long been linked to heart disease, lung cancer, and other chronic conditions, so it’s only natural that users spend more than their peers on doctors and prescriptions.
Lost productivity may be less obvious. Nevertheless, it is the greater drain on profits. Of course, this is partly due to smokers’ increased levels of absenteeism, or missed work, because of illness.
To avoid rising healthcare premiums, many businesses self-insure. Instead of submitting claims to an insurance company, these organizations pay employee medical bills straight from their respective treasuries.
The Ohio State team discovered that for each smoker on staff, self-insured firms spend an additional $2,000 per year on healthcare. Though most states allow the self-insured to levy a “tobacco surcharge” on employees who smoke, the proceeds aren’t always sufficient to offset the increased medical expenditures.
While these expenses take a toll, their impact pales in comparison to the damage wrought by lost productivity. Smokers miss more work than their colleagues, and when they do show up, they tend to underperform. As reported in the Ohio State study, this combination of absenteeism and presenteeism costs organizations $4,000 per smoker per year, twice the amount of tobacco-related medical bills.
Smokers are older than nonsmokers, suffer higher rates of chronic disease, and are more likely to regard themselves as unhealthy. It should be no surprise then that when it comes to taking sick leave, smokers outpace their co-workers by three days per annum. In their absence, their comrades are left to pick up the slack, sometimes at overtime rates.
The consequences can be toxic. Overwork has a way of denting morale, and if managers are pulled from supervisory roles, quality may suffer. In time, these byproducts will shrink profit margins as sure as paying time and a half.
Presenteeism, or lower on-the-job productivity, is even more corrosive. The Ohio State team estimated that the typical smoker costs his or her company approximately $3,500 per year in lost output. Smoke breaks account for the lion’s share with the remainder due to the effects of nicotine withdrawal. Between breaks, smokers experience a range of symptoms including irritability, impatience, and difficulty concentrating, any one of which will negatively impact productivity.
At first glance, these expenses may seem manageable. After all, the national smoking rate is only 14%. However, in low-wage sectors like construction, food service, and hospitality, nearly a third of workers light up. In these industries, tobacco can be the difference between profitability and just scraping by.
The same can be said for any operation that employs enough people. If 14% of Americans smoke, a staff of 125 would cost $100,000 per year in excess medical bills and diminished output - no matter the industry.
Regrettably, the Ohio State findings are merely the tip of the iceberg. Smoking squeezes earnings in other ways, too. Employee tobacco use means costlier housekeeping, restoration of smoke-damaged infrastructure, and heftier premiums for fire and property insurance.
Then there is the issue of secondhand smoke, which can depress retention among healthier, more productive nonsmokers and even expose an organization to legal liability. Companies may be held liable under several theories. A nonsmoker could seek compensation for discrimination if he or she has asthma or another disability exacerbated by poor air quality. The same person could sue for failure to provide a safe work environment. Alternatively, an injured party could skip the courts and file a worker’s comp claim, which, if accepted, would raise the firm’s premiums.
Fortunately, many tobacco users want to quit. Higher taxes have made cigarette smoking more expensive, and though smoke-free laws are not a panacea, they do make life uncomfortable for the average nicotine addict.
Of course, there are countless health reasons to kick tobacco products. According to smokefree.gov, the body begins to heal itself almost immediately after quitting. Within the first 20 minutes, heart rate and blood pressure ease. Within 12 hours, blood carbon monoxide levels return to normal. Within a year, the risk of coronary heart disease is halved.
Companies can help their smokers quit. One option is a workplace ban, but that could reinforce feelings of solidarity that some smokers derive from commiserating with fellow users. In low-wage sectors, this may be the probable outcome.
The better solution is a smoking cessation program. In this way, the company will be seen in a positive light, as a source of support for employees who wish to quit but lack the resources or know-how.
Cessation generates impressive returns. A 2017 study demonstrated that if just 5% of the federal workforce went tobacco-free, in five years’ time, the government would recoup more than $500 million. Predictably, the difference would be in costs related to absenteeism, presenteeism, and the treatment of smoking-related illnesses.
At the same time, providing quit assistance may bolster corporate culture if staff who shake tobacco develop feelings of loyalty towards the organization. The consequent jump in retention would save on recruitment and training. Down the road, it could yield higher product or service quality.
Certainly, these abiding benefits will only accrue if employees remain smoke-free. The typical user makes multiple quit attempts before meeting success. Reasons for relapse differ, but the most common trigger is stress.
A true tobacco cessation program will equip participants to handle life’s challenges without resorting to nicotine.
Currently, most employers offer smoking cessation benefits such as quit smoking seminars and telephone quitlines. Unfortunately, these solutions suffer from persistently low uptake and engagement due to the inconvenient nature of the solutions.
Cognitive behavioral therapy (CBT) treats addiction by teaching patients to recognize and understand the negative thought patterns that prompt them to use. They then learn to anticipate cravings and cope with situations that could result in relapse.
A 1998 study found that smokers who received CBT were twice as likely to quit as peers who underwent traditional behavioral counseling. The disparity grew over time. At the 12-month follow-up, the CBT group was more than three times as likely to be abstinent.
This was corroborated by a 2017 survey that examined the long-term outcomes of a workplace cessation program based around CBT and first-line medications like NRT and bupropion. Three out of four smokers who’d quit for a year were still smoke-free at the five-year check-in.
The Quit Genius program combines a digital CBT program, NRT and a connected Carbon Monoxide breath sensor to give folks the best possible chance of quitting smoking for good. There are other systems that blend NRT with elements of counseling, but this is where the similarities end. See the following table which compares Quit Genius with Quit For Life®.
As the table shows, Quit Genius goes further by offering a personalized content journey, unlimited one-on-one coaching, and round-the-clock craving support. Another key difference is that Quit Genius encourages users to develop a relationship with their Quit Coach as they will be engaging with the same Quit Coach throughout their journey. This is in stark contrast to conventional employer-sponsored tobacco cessation programs, which consist of a series of telephone coaching sessions with a different coach each time.
The program, which is available on Android and iOS, is flexible, on-demand, and built on scientifically-proven techniques like CBT and gamification that empower users to go smoke-free. To validate success, Quit Genius includes a carbon monoxide breath tester as well as monthly scorecards to detail the progress of each participant. More information can be found here.
Employee tobacco use costs billions of dollars per year in excess medical bills and productivity losses. It also depresses retention among nonsmokers and may expose an organization to legal liability. The good news is that cigarette taxes, smoke-free laws, and health concerns have spurred many smokers to quit.
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