Publication
Cost and benefit analysis of smoking cessation in the workplace
6. Conclusions and recommendations
6.2 Recommendations
- HEBS produces a document offering guidance on the design and implementation of workplace policies. This would draw on the results of this report, in particular highlighting the advantages and disadvantages of different policies in terms of the costs and benefits which might result from these policies, and the potential problems that may be experienced.
- HEBS produces guidance on how to choose effective cessation help. Employers need to be made aware of the approaches which are supported by scientific evidence, and those for which there is no evidence but which may be useful. Employers also need guidelines on how to assess value for money. The costs and benefits which may result from implementation of a cessation policy should be highlighted. Employers should be made aware of the benefits beyond the health of their employees.
- Such a document may provide a simple model by which employers may calculate the costs which employee smoking imposes upon their business. The employer may then assess the net costs or benefits which may be expected if cessation help is offered to employees. This may follow the simple model provided with the report, which would allow an employer to assess such a programme by entering specific information for his or her workplace.
6.1 Conclusions
Employee smoking imposes considerable costs on employers. The literature review identified several major costs of employee smoking: absence from work; lost productivity; increased insurance premiums; costs due to passive smoking; occupational health costs; and costs of damage to plant and machinery. Costs in terms of productivity losses and absence as a result of smoking related disease can be estimated, but the impact upon a particular employer will depend on a wide range of employer specific factors.
The telephone survey and the focus group work showed that most Scottish employers have restrictive smoking policies. The two major driving forces behind the widespread implementation of restrictive smoking policies over recent years have been legislation (both from the EU and interpretation of existing legislation) and concerns for employee health and safety. The other benefits of a restrictive smoking policy were rarely considered. Both the survey and the focus group work showed that employees did not expect to be able to smoke freely at work, although a total ban on smoking without any provisions for smokers was generally found to be unacceptable to smokers. Besides being unpopular with smokers, total smoking bans may actually increase insurance premiums. Forcing smokers outside also causes problems such as litter and cigarette butts strewn outside buildings, together with the adverse impact on the firm’s image which this creates.
Cessation help was offered by 29% of firms in the telephone survey. However, none of the firms had undertaken any evaluation of how effective the policy had been. Most companies had no idea of which programmes were successful or what provided value for money. Furthermore, the focus group work highlighted low take up rates when help was actually offered. Employers were found to be unaware of the potential benefits of a smoking cessation policy. Cost savings to the firm were not thought important, or had not been considered, despite evidence in the literature pointing to the potential savings to businesses.
The simulations presented indicate that the cost to employers in Scotland may be in the region of £293 million per annum in terms of lost productivity, although estimates are very sensitive to the assumptions made. Costs in terms of excess absence were estimated at £33 million per annum, with fire damage in the region of £81 million as a result of smoking. There are other potential costs such as damage to plant and machinery and the effects of passive smoking for which generalisable values cannot be made, since the effects will depend upon variables of which no information is as yet available. Employers may also face legal costs if found guilty of failing to protect employees from the dangers of tobacco smoke.