Cost and benefit analysis of smoking cessation in the workplace

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Cost and benefit analysis of smoking cessation in the workplace


Contents:	Summary 1. Introduction 2. Review of the literature 3. Survey of Worksites in Scotland 4. Focus groups and interviews with occupational health and personnel staff 5. The cost of employee smoking in Scotland 6. Conclusions and recommendations 7. References Appendices

Appendices

Appendix 2. Questionnaire results

Details of Sample

Total sample size:	200

Total successful responses:	167

Refusal to participate:	3

Could not contact person responsible for policy:


Firm could not be contacted / ceased trading:	8

Section 1: Smoking policy

Q1. Does your company have any sort of smoking policy?

YES	156	Go to Q2	1
			SMKPOLCY
NO	11	Go to Q3	2

Q2. Is the policy written down?

YES	133	Go to Q4	1
			WRITTEN
NO	23	Go to Q4	2

Q3. Are you planning or developing a smoking policy at the moment?

YES	1*	Go to Q4 THEN Q15	1
			PLANDVLP
NO	11	Go to Q15	2

* employer re-designing smoking policy; current policy is used for the purpose of this analysis

Q4. What are the key elements of your policy?

Help to employees to stop smoking	49	1

Total smoking ban	57	2

Partial ban

			FEATURE
smoking only allowed in some places (smoke room)	89	3

smoking only allowed at some times	3	4

non-smoker protection from passive smoking at all times		5

more complex (ask for details)	7*	6

* smoking allowed if agreed by all persons sharing an office, and also permitted for sole occupants of an office.

Q5. Have any problems been encountered introducing the policy?

YES	41	Please detail	1
			PROBLEMS
NO	115	Go to Q6	2

productivity losses due to smoke breaks; non-smoking staff aggrieved at smokers having longer breaks (17)
smokers congregating at entrance to building creating a negative corporate image and large amount of litter (9)
enforcement I; ‘fly-smoking’ in toilets and out of sight areas (6)
enforcement II; senior staff ignoring ban (3)
complaints from smokers (16)

* figures do not add to 41 due to multiple responses

Q6. Has your company evaluated the smoking policy?

YES

Please give details

Go to Q7

				EVLUATE1
NO	156	Go to Q7		2

Q7. Does the policy offer help to employees who want to stop smoking?

YES	49	Go to Q8	1
			STOPHELP
NO	107	Go to Q15	2

Section 2: Help to Employees Wanting to Stop Smoking

Q8. Who will offer help to employees who want to stop smoking? WHOHELP

Occupational health staff	28	1

Outside consultants	10	2

Telephone helpline	-	3

Money to staff to buy own help	3	4

Other (please give details)	8*	5

* ‘Other’ included 1 employer providing leaflets and contact and 7 employers who stated that they would offer help if approached by employees but as yet the nature of the help is unknown.

Q9. How did you choose the type of help you are offering?

Don’t know (26)
Local Health Board (7)
From consultations with employees (2)
Directive from company HQ (12)

Q10. Have any problems have been encountered with this element of the policy?

YES	2	Please detail then go to Q11	1
			STOPPROB
NO	47	Go to Q11	2

- low take up (2)

Q11. Are smokers generally satisfied with the help being offered?

YES	11	Go to Q12	1
			STSFIED
NO	3	Go to Q12	2

* don’t know (35)

Q12. Has your company evaluated the help element of the policy?

YES

Please give details

Go to Q14

				EVLUATE2
NO	49	Go to Q13		2

Q13. Would you be interested in details of the cost effectiveness of the programme?

YES	1	Go to Q14	1
			WANTINFO
NO	48	Go to Q14	2

Q14. Would more guidance on the kinds of help available and how to find this help be useful to you?

YES	5	Go to Q15	1
			MOREHELP
NO	44	Go to Q15	2

Section 3: Costs and Benefits

Q15. Do you know how many smokers work in your company?

Number

Range; 17-80%

PREV

(estimates provided by 9 employers)

Q16. What do you think are the main benefits of implementing a workplace smoking policy?

¯ absenteeism (2)
cost savings (19)
health (130)
hygeine (30)

legal considerations (9)
employee morale (9)
safety (40)

Q17. What do think are the benefits to be gained from helping employees to stop smoking?

health benefits (42)
promotes the ‘caring’ image of the firm to employees (1)

Q18. Do you think there are any costs involved when implementing a workplace smoking policy or a programme to help smokers stop smoking?

reduced productivity as smokers take smoke breaks (17)
equipment and space needed (smoke room, extractor fans etc)(9)

Appendix 3. Simulations

Simulation 1

SIC CODE 4

EMPLOYMENT: Male: 250 Female: 150

SMOKING RESTRICTIONS: No smoking, no extra smoke breaks allowed

Applying prevalence of smoking:


Male	0.33	x 250	= 82.5	smokers
Female	0.36	x 150	= 54	smokers

Time spent smoking per day per worker: 0 mins

Cost of time per annum:


M	0 mins	x 82.5	x £6.91	= £0	x 230 days	= £0
F	0 mins	x 54	x £4.76	= £0	x 230 days	= £0
						£0

Time absent from work:


M	7.2 hrs	x 82.5	x £6.91	= £4104.54
F	7.2 hrs	x 54	x £4.76	= £1850.69
				£5955.23

Smoking cessation policy: Success rate = 25%

Productivity gain:

M	0.25	x 0	= £0
F	0.25	x 0	= £0
			£0

Reduction in cost of absence

M	0.25	x 4104.54	= £1026.135
F	0.25	x 1850.69	= £462.672
			£1488.807

Total savings = £1488.807

Simulation 2

SIC CODE 3

EMPLOYMENT: Male: 250 Female: 150

SMOKING RESTRICTIONS: Nil

Applying prevalence of smoking:


Male	0.33	x 250	= 82.5	smokers
Female	0.36	x 150	= 54	smokers

Time spent smoking per day per worker: 5 mins

Cost of time per annum:


M	5 mins	x 82.5	x £7.02	= £48.2625	x 230 days	= £11100.375
F	5 mins	x 54	x £4.90	= £22.05	x 230 days	= £5071.5
						£16171.875

Time absent from work:


M	7.2 hrs	x 82.5	x £7.02	= £4169.88
F	7.2 hrs	x 54	x £4.90	= £1905.12
				£6075

Smoking cessation policy: Success rate = 25%

Productivity gain:

M	0.25	x 11100.375	= £2275.09375
F	0.25	x 5071.5	= £1267.875
			£4042.96875

Reduction in cost of absence

M	0.25	x 4169.88	= £1042.47
F	0.25	x 1905.12	= £476.28
			£1518.75

Total savings = £5561.71875

Simulation 3

SIC CODE 9

EMPLOYMENT: Male: 500 Female: 500

SMOKING RESTRICTIONS: Smokers take 25 mins morning & afternoon

Applying prevalence of smoking:


Male	0.33	x 500	= 165	smokers
Female	0.36	x 500	= 180	smokers

Time spent smoking per day per worker: 50 mins

Cost of time per annum:


M	50 mins	x 165	x £5.96	= £0	x 230 days	= £188485
F	50 mins	x 180	x £4.67	= £0	x 230 days	= £161115
						£349600

Time absent from work:


M	7.2 hrs	x 165	x £5.96	= £7080.48
F	7.2 hrs	x 180	x £4.67	= £6052.32
				£13132.8

Smoking cessation policy: Success rate = 25%

Productivity gain:

M	0.25	x 188485	= £47121.25
F	0.25	x 161115	= £40278.75
			£87400

Reduction in cost of absence

M	0.25	x 7080.48	= £1770.12
F	0.25	x 6052.32	= £1513.08
			£3283.20

Total savings = £90,683.20

Appendix 4. Identifying the productivity costs of employee smoking

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Notes

1.	Benefits: better health of workers asresult of lower cigarette consumption, no productivity losses due to breaks,lower insurance, no damage to premises. Costs: smokers aggrieved at not being able to smoke.
2.	Benefits: freedom of smokers Costs: passive smoking risks, productivity losses due to lighting,drawing etc, damage to workplace if indoors, insurance and fire risks.
3.	Benefits: protects non smokers,productivity losses limited to permitted breaks, passive smoking problemsavoided, avoids higher insurance and reduces fire risks. Costs: provision of smoke room.
4.	As (3) except potentially larger productivitylosses. Costs may depend upon the distance to the smoke room.
5.	As (3) except smoke room costs avoided. Extracost may be adverse corporate image if smokers congregate in areas such ascompany doorways.
6.	As (5) except productivity losses may begreater if smokers have to travel a long distance to areas where smoking ispermitted.

Appendix 5. Costs of employee smoking to an employer and benefits of smoking cessation help: productivity and absence

COSTS OFEMPLOYEE SMOKING TO AN EMPLOYER AND BENEFITS OF SMOKING CESSATION HELP:PRODCTIVITY AND ABSENCE

	*PRODUCTIVITY*

	Prevalence	No. of Workers	No. Smokers		Time smoke/day (mins)	Totl. Time	Wage Rate	Total Cost	Total cost per annum
Male	0.33	1000	330		5	27.5	£ 7.02	£ 193.05	£ 44,401.50
Female	0.36	875	315		5	26.25	£ 4.90	£ 128.63	£ 29,583.75
									£ 73,985.25
	*TIMEABSENT*

	Smokers	Excess/Smkr(hrs/yr)	Total loss		Total cost
Male	330	7.2	2376		£ 16,679.52
Female	315	7.2	2268		£ 11,113.20
					£ 27,792.72

					Total Prody loss	£ 73,985.25
					Total Absence	£ 27,792.72

					Total cost	£ 101,777.97

					Productivity Gain
	Smoking cessationSuccess Rate			M	£ 13,320.45
		0.3		F	£ 8,875.13
				Total	£ 22,195.58

					Absence gain
				M	£ 5,003.86
				F	£ 3,333.96
				Total	£ 8,337.82

					Total saving
					£ 30,533.39

		Cost of cessationpolicy			£ 1,000.00

		Net benefits			£ 29,533.39

Appendix 6. Estimating the cost of employee smoking in Scotland: productivity and absence costs

ESTMATINGTHE COST OF EMPLOYEE SMOKING IN SCOTLAND: Productivity and AbsenceCosts


	PRODUCTIVITYCOSTS OF EMPLOYEE SMOKING

	Male	Male full time	Male part time	Smoking prev.
		895,000	97,000	0.332

		Proportion of sites	Employees	Time lost (min)	Wage	Cost of time/day	Total Cost/Day
	Smoke room	0.533	166,958	30	£ 8.86	£ 4.43	£ 739,623.88
	Smoke free	0.341	106,816	10	£ 8.86	£ 1.48	£ 157,730.92
	No policy	0.066	20,674	5	£ 8.86	£ 0.74	£ 15,264.28
£ 912,619.08

				Cost per annum(male)=		£ 209,902,388.74

	Female	Female full time	Female part time	Smoking prev.
		526,000	431,000	0.362

		Proportion of sites	Employees	Time lost (min)	Wage	Cost of time/day	Total Cost/Day
	Smoke room	0.533	143,069	30	£ 7.09	£ 3.55	£ 507,181.23
	Smoke free	0.341	91,532	10	£ 7.09	£ 1.18	£ 108,160.60
	No policy	0.066	17,716	5	£ 7.09	£ 0.59	£ 10,467.15
							£ 625,808.99

				Cost per annum(female)=		£ 143,936,067.13

		Total cost perday=	£ 1,538,428.07		Total cost perannum=		£ 353,838,455.87


		ABSENCE COSTS AS A RESULT OFEMPLOYEE SMOKING
			Excess absence / year(hours)	Cost
	Male		7.2	£ 10,650,583.84

	Female		7.2	£ 7,303,409.74
			Cost of absence perannum=	£ 17,953,993.59

			Total cost of employeesmoking per annum=	£ 371,792,449

Appendix 1. Literature search

Medline 1991 - Dec 1995

	Search terms	Results
1	(wellness adj program$).tw.	35
2	(continuing adj medical adj program$).tw.	0
3	(preventive adj pulmonary adj practice).tw.	0
4	(individual adj counseling adj practice$).tw.	1
5	(health adj promotion adj program$).tw.	190
6	(employee adj assistance adj program$).tw.	34
7	(holistic adj health).tw.	30
8	(health adj promotion).tw.	1467
9	(better adj health).tw.	177
10	(social adj control adj work).tw.	1
11	(medical adj surveillance adj program$).tw.	20
12	or/1-11	1738
13	(preventive adj pulmonary adj practice$).tw.	1
14	or/1-2,4-11,13	1738
15	workplace.tw.	1580
16	worksite.tw.	212
17	(worksite adj environment).tw.	1
18	factory.tw.	625
19	office.tw.	3513
20	(health adj care adj environment).tw.	164
21	15 or 16 or 17 or 18 or 19 or 20	5962
22	16 or 17	212
23	smoking.tw.	11437
24	(smoking adj polic$).tw.	75
25	(smoking adj ban).tw.	24
26	-	-
27	23 or 24 or 25	11437
28	(smoke adj free adj environment).tw.	12
29	27 or 28	11443
30	effectiv$.tw.	87052
31	benefit$.tw	21287
32	30 or 31	104700
33	cost$.tw.	21183
34	cost-effectiv$.tw.	4328
35	cost$ adj benefit$).tw.	949
36	33 or 34 or 35	21183
37	14 or 27	12993
38	21 and 37	464
39	32 or 36	117644
40	38 and 39	92
41	14 or 29	12999
42	21 and 41	464
43	39 and 42	92
44	40 or 43	92
45	smoking/	10129	*
46	smoking/pc [prevention and control]	1287	*
47	workplace/	438	†
48	smoking cessation/mt [methods]	394	*
49	smoking cessation/	1507	*
50	attitude to health/	5402	*
51	health behaviour/	2261	*
52	health promotion/	3916	*
53	occupational health services/	810	*
54	program evaluation/	2629	*
55	occupational health/	1722	*
56	occupational exposure/pc [prevention and control]	226	*
57	organizational policy/	1214	*
58	tobacco smoke pollution/pc [prevention & control]	135	*
59	health care costs/	2303	**
60	preventive health services/ec [economics]	121	*
61	preventive health services/og [organization & administration]	174	*
62	employer health costs/	63	**
63	cost-benefit analysis	4481	**
64	health education/	4293	*
65	health policy/	4914	*
66	health benefit plans, employee/	393	*
67	health benefit plans, employee/ec [economics]	154	**
68	or/45-46, 48-53, 55-58, 60-61, 64-66	31890	*
69	54 or 59 or 62 or 63 or 67	9190	**
70	68 and 69	1420
71	47 and 70	15
72	40 or 71	104
73	71 not 40	12

Notes

*	smoking/smoking policy and wellness programmes
**	cost-benefit analysis and evaluation
†	workplace

Medline (1984 - 1990)

	Search terms	Results
1	(wellness adj program$).tw.	50
2	(continuing adj medical adj program$).tw.	0
3	(preventive adj pulmonary adj practice).tw.	0
4	(individual adj counseling adj practice$).tw.	0
5	(health adj promotion adj program$).tw.	181
6	employee assistance program$.tw.	45
7	holistic health.tw.	46
8	(health adj promotion).tw.	1195
9	(better adj health).tw.	160
10	(social adj control adj work).tw.	0
11	(medical adj surveillance adj program$).tw.	17
12	or/1-11	1481
13	workplace.tw.	1443
14	worksite.tw.	243
15	(worksite adj environment).tw.	1
16	factory.tw.	771
17	office.tw.	3837
18	(health adj care adj environment).tw.	103
19	(workplace adj environment).tw.	27
20	13 or 14 or 15 or 16 or 17 or 18 or 19	6320
21	smoking.tw.	11666
22	(smoking adj polic$).tw.	56
23	(smoking adj ban).tw.	9
24	(smoke adj free adj environment).tw.	12
25	21 or 22 or 23 or 24	11672
26	effectiv$.tw.	94784
27	benefit$.tw	17831
28	cost$.tw.	18754
29	cost-effectiv$.tw.	3361
30	(cost$ adj benefit$).tw.	843
31	26 or 27 or 28 or 29 or 30	122206
32	12 or 25	13034
33	20 and 32	493
34	31 and 33	111
35	smoking/	13436
36	smoking/pc [prevention and control]	1955
37	smoking cessation/mt [methods]	7
38	smoking cessation/	18
39	attitude to health/	6007
40	health behaviour/	917
41	health promotion/	3695
42	occupational health services/	1764
43	occupational health/	131
44	occupational exposure/pc [prevention and control]	18
45	organizational policy/	73
46	tobacco smoke pollution/pc [prevention & control]	126
47	preventive health services/ec [economics]	93
48	preventive health services/og [organization & administration]	254
49	health education/	6862
50	health policy/	3951
51	health benefit plans, employee/	358
52	health benefit plans, employee/ec [economics]	114
53	or/35-52	33466
54	programme evaluation/	1114
55	health care costs/	6
56	employer health costs/	1
57	cost-benefit analysis	3436
58	health benefit plans, employee/ec [economics]	114
59	54 or 55 or 56 or 57 or 58	4615
60	employment/	2841
61	53 and 59	670
62	60 and 61	4
63	62 not 34	4
64	34 or 63	115

Medline 1976 - 1983

	Search terms	Results
1	(wellness adj program$).tw.	3
2	(continuing adj medical adj program$).tw.	0
3	(preventive adj pulmonary adj practice).tw.	0
4	(individual adj counseling adj practice$).tw.	0
5	(health adj promotion adj program$).tw.	21
6	employee assistance program$.tw.	16
7	holistic health.tw.	46
8	(health adj promotion).tw.	250
9	(better adj health).tw.	55
10	(social adj control adj work).tw.	0
11	(medical adj surveillance adj program$).tw.	8
12	or/1-11	365
13	workplace.tw.	375
14	worksite.tw.	41
15	(worksite adj environment).tw.	0
16	factory.tw.	720
17	office.tw.	2519
18	(health adj care adj environment).tw.	14
19	(workplace adj environment).tw.	13
20	13 or 14 or 15 or 16 or 17 or 18 or 19	3631
21	smoking.tw.	5870
22	(smoking adj polic$).tw.	7
23	(smoking adj ban).tw.	1
24	(smoke adj free adj environment).tw.	1
25	21 or 22 or 23 or 24	5871
26	effectiv$.tw.	54776
27	benefit$.tw	8753
28	cost$.tw.	10432
29	cost-effectiv$.tw.	1125
30	(cost$ adj benefit$).tw.	557
31	26 or 27 or 28 or 29 or 30	70094
32	12 or 25	6228
33	20 and 32	108
34	31 and 33	11
35	smoking/	9995
36	smoking/pc [prevention and control]	1090
37	smoking cessation/mt [methods]	0
38	smoking cessation/	0
39	attitude to health/	4484
40	health behaviour/	8
41	health promotion/	907
42	occupational health services/	1403
43	occupational health/	1
44	occupational exposure/pc [prevention and control]	1
45	organizational policy/	0
46	tobacco smoke pollution/pc [prevention & control]	24
47	preventive health services/ec [economics]	69
48	preventive health services/og [organization & administration]	182
49	health education/	6000
50	health policy/	1262
51	health benefit plans, employee/	257
52	health benefit plans, employee/ec [economics]	68
53	or/35-52	22775
54	programme evaluation/	7
55	health care costs/	2
56	employer health costs/	0
57	cost-benefit analysis	2700
58	health benefit plans, employee/ec [economics]	68
59	54 or 55 or 56 or 57 or 58	2769
60	employment/	2822
61	53 and 59	262
62	60 and 61	3
63	62 not 34	3
64	34 or 63	14

B.I.D.S. 1983 - 1995

Search Strategy:

(wellness + program*), (smok*) + (workplace, worksite, factory, office) + (effectiv*, benefit*, cost*, cost-effectiv*)

Hits = 99.

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