Abstract
Cigarette smoking has several adverse effects on an employee’s health, the productivity of the organization, and the overall economy of the nation. Several laws and policies have been initiated and implemented since the knowledge about the illness and deaths caused by smoking have been discovered. Different states have adopted these policies in different ways, ultimately aiming to ensure a healthier working labor and healthier future generations.
The current paper provides an introduction to the ill effects of smoking, and the advantages and disadvantages of punitive laws and supportive programs to assist employees to quit smoking. This followed by a discussion on the structure of a successful policy. Future research needs to be conducted to develop more policies and programs that organizations could use to help create healthy working environments.’
Introduction
The role of smoking in causing health hazards such as cancers related to mouth and the respiratory tract, cardiovascular diseases, strokes, emphysema, and chronic obstructive lung diseases has been long established. Tobacco has adverse effects both on the health of an employee and the effective functioning of an organization. The United States companies spend nearly $95 million on their employees to treat ailments caused by direct inhalation of smoke or from secondary or side-stream cigarette smoke. It is estimated that smokers use the health care services approximately 50% more than those who do not smoke. Various measures have been taken in the past few decades to contain smoking at working places to ensure a healthier smoke-free environment.
Hospitals were one of the first organizations to implement restrictive smoking policies at work. These policies were introduced in response to the adverse effects of smoking, and classification of nicotine as a potential carcinogen. The hospitals were willing to promote smoke free environments, and to emphasize the harmful effects of tobacco smoke. The success rate of these restrictive policies varied in different organizations from reducing the number of cigarettes smoked per day, to complete avoidance of cigarettes, to no effect at all. Various studies have been conducted in both health care related organizations and non-health care related organizations to study the effect of these policies on the smoking behavior of employees.
This paper elaborates on the effects of smoking on the health of the workforce, economy, and the productivity of an organization, followed by comparison of the effects of punitive restrictive policies and a caring approach, and a few recommendations for policy designing. The restrictive policies should ultimately result in a healthier labor, regardless of the nature of the organization.
Effects of Smoking
Statistical data has shown staggering number of deaths and illness caused by cigarette smoke. Smoking in various forms has accounted for several types of oral precancerous lesions and cancers. The nicotine component of tobacco has shown detrimental effects on the cardiovascular system, resulting in strokes, hypertension, and arterial diseases. Medical institutions have recorded several lung cancers, and reduction in lung capacities in several smokers. Secondary or side-stream smoke has equally adverse effects on non-smokers. Work places which have restrictive policies requiring the smokers to use the designated areas to smoke still release toxins into the working environment. According to reports, 46,000 heart disease related deaths and 3,400 deaths due to lung cancer are observed among the nonsmoking US adults each year (CDC, 2011).
Regardless of smoking in a health care work environment, or non-health care organization, smoking leads to illnesses, ultimately creating a burden on the employers. Employers also have a chance to feel biased while hiring smokers and non-smokers; the obvious reason being higher health care costs involved for the smokers. it is estimated that the United States spends almost $2,000 to $5,000 annually per employee more due to tobacco smoke (Colosi, 1988). Hence, it can be derived that the smoking group of employees create an economic burden on the organization.
Failure to implement restrictive policies at work places also has effects on the social work atmosphere. With the increasing awareness of the adverse effects of tobacco, the non-smoking group of employees would demand the implementation of restrictive policies. A few organizations allow smoking in designated areas, which include the entrances and exists. This creates a bad social impression on the organization. The designated areas could also lead the baseline smokers to be influenced to smoke more due to peer pressure. Organizations which encourage smoking cessation programs have a better recognition in general than those which do not have such programs.
Restrictive Laws and Policies on smoking and their effects
The implementation of the restrictive policies on smoking started in the 1980s with the spread of public awareness about the adverse effects of tobacco on health. The prime initiation for this movement was a report from the Surgeon General in 1986. The Joint Commission on the Accreditation of Healthcare Organizations started requiring hospitals to have restrictive smoking policies for accreditation in 1992. The role of nicotine as a carcinogen was declared by the US Environmental Protection Agency in 1993, which further intensified the movement.
Both the public and private work places have been showing increasing implementation of restrictive smoking policies. All the federal work places require restricting smoking only to designated areas (US DHHS, 1989). One of the Healthy People 2010 objectives required all 50 states have laws that restrict smoking in public work places. By 2010, 26 states prohibited smoking in indoor areas of work and eating places. Delaware was the first state to implement a comprehensive smoke free law in 2002. The laws were elaborated and intensified gradually in a few states. The southern states are slightly lagging in progress to prohibit smoking in working areas. However, several cities and communities have locally adopted comprehensive smoke free laws.
The ultimate goal of these restrictive laws and policies is to ensure a healthier nation and more productive work places. Discrimination of smokers is not an intention of these policies. In fact, in the present scenario, 29 states have laws that prohibit discrimination against smokers during employment.
Several studies have concluded that the restrictive smoking policies have lead to reduction in cigarette consumption to a great extent. Some cases have shown complete abstain from smoking in baseline smokers. The success of these policies in health care settings has lead to reduction in ETS (Environmental Tobacco Smoke), creating a positive impression among the patients, and serving as a motivation. with the implementation of these clean indoor laws, employees who smoke, consumed 11 to 15% less cigarettes than the average.
However, smoking is considered addictive, and related to psychological issues. Mere implication of these restrictive laws could stress a few employees. Peer and organizational support will further assist the smokers in quitting tobacco. The purpose of these laws is to protect both the smokers and non smokers from exposure to tobacco smoke. These laws have also been successful in preventing several young adults being influenced to smoke. In addition, since employees spend a considerable time at work, these policies have further supported them to restrict smoking.
Supportive programs encouraging smokers to quit smoking
In some cases, banning smoking at workplaces could be risk factor for lowering employees’ morale. The implementation of these laws is a complicated issue since it isolates and creates an oppressed minority group within the organization. There could be mixed opinions from smokers and non-smokers about the implementation of these laws. Sympathizing non-smoker group of employees further complicate the implementation of punitive laws against smoking at work places. Social sensitivity plays a major role in determining the implementation of laws and policies. In such cases, employers look for ways which encourage and support smokers to quit smoking. These programs will help reduce costs for health care services required for the smokers.
Many organizations have programs such as health awareness programs, talks, and seminars. These programs provide moral support and are socially more acceptable compared to bans or punitive laws. Most of these programs are conducted during work hours, reducing discomfort to the employees. Support from peers and the employer have shown to have appositive effect on smokers. Providing nicotine replacement therapies free of cost also motivates employees. These programs involve minimal cost, but usually yield positive results, and are way less than the medical costs incurred due to smoking induced illnesses or disabilities. They improve the productivity of the organization at a minimal cost, while maintaining employee morale. Providing coverage for smoking cessation counseling programs, pharmaceutical aids, and providing information and literature are other benefits that can be provided.
These programs do not show immediate results as do punitive laws and policies. The smoking group of employees might not show interest or motivation to quit smoking unless required by a punitive law or policy. This will lead to continued exposure of environmental tobacco smoke to both the smokers and non-smokers. Implementing these supportive programs during work hours could also lead to decreased productivity. Lack of interest and motivation to attend these awareness camps or programs will make the investment go waste. Mere implementation of these programs without a punitive law will lead to increase in lenience among the employees, disrespect towards co workers and the employer, and overall lack of a professional work atmosphere.
Discussion
Both the punitive laws and the supportive programs have advantages and disadvantages. The restrictive smoking policies have shown a statistical decrease in the percentage of cigarette consumption among the working population. Smoking at work has to be dealt in such a way that it does not lower employee morale, and at the same time does not reduce the productivity of the organization.
Mere implementation of a punitive regulatory policy will create physical stress on smoking group of employees due to nicotine addiction, reduce their productivity, result in mental stress, and decrease the employee morale and commitment to the organization. On the other hand, mere implementation of a cessation program will encourage a few smokers, but will take a longer time to create a healthier environment.
Hence, implementation of a punitive policy to restrict smoking at work place, supported by a cessation counseling or therapy would have the greatest benefit. It will help in creating a smoke free healthy work environment as soon as the policy is implemented; and remains socially acceptable since the organization is supportive to its employee by providing the required assistance to quit smoking. Having a healthier group of employees will result in less cost for health care services, and more productivity, all the while maintaining employee morale.
Developing such a policy, which is beneficial to both the health of the employees and to the organization, will require efforts in surveying the opinions of employees, strategically developing a policy, evaluating the possible consequences of the policy, implementation, and continual evaluation of its success. The policy should also be fair, uniform, and applicable to all employees and management staff including the director, on all shifts, and at all premises of the organization.
Conclusion
Smoking is hazardous and needs to be banned to ensure a healthier nation and healthier future generations. Restrictive laws and policies on smoking at work places have been through several changes and modifications. They are still not accepted uniformly nation-wide. Different states have adopted different policies. The restriction originally started in health care settings to make a statement that smoking is injurious to health. The non-health care related organizations have also adopted the policies and altogether have been successful in decreasing the overall cigarette consumption.
The advantages and disadvantages of implementing punitive laws alone and the supportive programs alone have been discussed. The most successful policy will include strict restriction of smoking within the organization’s premises and a supportive program to assist the employee to quit smoking. Future research should be conducted to evaluate the success of different policies and programs to ensure a health work force.
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