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Smoke 'Em If You Got 'Em - Or Not...

Some random pickups on smoking from my RSS feed this week suggest cessation programs are worth the money, and maybe the thing to do if ADA expands into this area. 

First, Tanya Barham, CEO of wellness firm, Recess, and a future contributor to a Benefits blog we're Leary launching in December, riffs on the business case for smoking cessation programs in the Portland Business Journal:

"The Centers for Disease Control estimate that about 23 percent of American adults smoke.  And according to a study in the Journal of Occupational and Environmental Medicine, men who smoke incur $15,800 (in 2002 dollars) more in lifetime medical expenses and are absent from work four days more per year than men who do not smoke. Women who smoke incur $17,500 (in 2002 dollars) more in lifetime medical expenses and are absent from work two days more each year than nonsmoking women.

CDC statistics show that 70 percent of smokers would like to quit, but few are able to do so on their own. The irony is that even though the National Business Group on Health reports that 82 percent of employers state they should take steps to help employees quit smoking, only 24 percent of employers actually offer such benefits.

The numbers show that simply banning smoking in the workplace is not an effective means of enticing smokers to quit. Even though 67 percent of employers enforce a smoke-free workplace policy, employees of such workplaces say:

  • Some 78 percent state the company's policy is not effective in motivating them to quit.
  • A mere 14 percent claimed to attempt quitting because of their employer's smoke-free workplace policy.
  • Another 15 percent report starting to smoke more while not at work.

As to the effectiveness of cessation programs, the U.S. Department of Health and Human Services Clinical Practice Guidelines state that tobacco use treatment doubles the chance that smokers will manage to kick the habit. The guidelines recommend counseling, medications or a combination of both as the most effective means to combat smoking in the workplace."

Next up, friend of the Capitalist Michael Moore explores ADA implications related to smoking, and smoking cessation programs:

"Smokers are feeling the heat in the workplace through smoke-free workplace policies. Jon Hyman at the Ohio Employer’s Law Blog has a post asking Are there legal risks with smoking bans?  He notes that pushing back on these employer initiatives are  29 states which have enacted laws protecting employees who smoke from discrimination.

Pennsylvania has no law protecting smokers from discrimination. To the contrary, Pennsylvania’s new Clean Indoor Air Act mandates smoke-free workplaces and precludes employees from smoking indoors. However, the law allows employers to prohibit smoking anywhere on company property; it does not prevent the continuation of outdoor smoking areas. Employers are left with the sometimes delicate task of crafting a policy concerning outdoor smoking and monitoring the break schedules of employees who wish to smoke. In addition, many wellness programs have targeted smoking with cessation programs coupled with both financial incentives and penalties.

The Americans with Disabilities Act was recently amended to expand the definition of “disability”to the point that it may encompass nicotine addiction. The few ADA cases on “smoking” as a disability have not recognized a claim based on the pre-amendment definition of disability. However, the rationale for denying disability status to “smoking” or “nicotine addiction” is squarely predicated on the remedial nature of the condition exempting it from coverage of the ADA as expounded in Sutton v. United Airlines, Inc."

Smoking covered by the ADA?  What's next, alcohol?  Wait a second...


Chris - Manager's Sandbox

Of course smoke-free workplaces don't encourage people to quit. What incentive is there at all for an employee to stop? Because they have to walk an extra 20 feet to smoke off company grounds?

Marsha Keeffer

I think this is going to be something that companies take a look at when trying to reduce their high cost of health insurance. Smokers skew the pool and cost more to cover. At some point, that will probably be passed on - if it isn't now.

Tanya @ Recess

Honestly the real cost of smokers in the near term anyway is the productivity and absenteeism. Research shows that smokers and drinkers tend to spend less time worrying about their health across the board and so may not visit the doctor when sick. Thing is, 1 in 3 smokers will eventually find an easy way to quit smoking. They will die. And the dying usually doesn't happen overnight. Thing is that between 20 smoke breaks per day (now with the extra time tacked on to walk that 20 feet, which, is only a small barrier for someone truly addicted) and the increased susceptibility to colds and respiratory diseases you get those four extra sick days. This is not to mention the sick days they will have to take on behalf of their children if those children are exposed routinely to second hand smoke. So most employers are going to take the biggest hit on smoking as a product of absenteeism and then later if the smoker's health seriously deteriorates, as a medical claim cost.


Chris/Marsha -

Thanks for stopping by - good thoughts...

Tanya - Way to get me back on the cessation groove. Dying is later, so If I want ROI, I have to look for absenteeism and productivity... Make for a good post at the new blog...

Jason Seiden

I once worked for a smoker. I'd head down the dumpster behind our building once or twice a day during his smoke break... and wouldn't you know it, but we got a ton done in those 10 minutes (including the elevator ride). It was uninterputed time, away from the office, and in 10 minutes we could vent, joke, prioritize, and come up with plans of action.

Of course, that was not the norm, but I do think that as smoking goes the way of the dinosaur, that we at least recognize that for some people, a smoke break represented more than the cigarette... and that on some level, for some people, it had value, too.

Now if you'll excuse me, I need to run downstairs and take a deep breath break.

Michael Moore


The ADA Amendments Act will require employers to retool thinking on disabilities. Get over thinking about whether the condition is a covered disability and start evaluating accommodations. Addictions like nicotine and alcoholism are good because they reorient thinking. Employers don't necessarily need to abrogate their work rules as an accommodation. If you don't allow other employees to smoke and drink at work based on the obvious effects on other employees, then you don't need to change your rules. You can also uniformly enforce your other rules on productivity, attendance and break times. However, other accommodations like time off for treatment, cessation programs, etc. need to be considered. The importance is engaging in the "interactive process" to determine whether an accommodation might enable to person to meet the essential functions of the job. Skipping the process because you don't think someone is disabled will likely cause legal problems. Just wait for claims based on chionophobia (excusing you from driving to work in the snow), perfume sensitivity (making HR the fragrance police), or seasonal adjustment disorder (necessitating a window in your cubical). Don't waste a lot of time arguing whether these conditions are disabilities. Start evaluating alternatives to the requested accomodations.

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