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Assessing Tobacco Use Policies in the Workplace
Carol A. Riker, RN, MSNAssociate [email protected]
Ellen J. Hahn, DNS, RNAssociate Professor
UK College of Nursingwww.mc.uky.edu/tobaccopolicy/
Adult Smoking in Kentucky and the U.S., 2002
32.6
22.8
34.8
25.2
30.5
20.7
0
5
10
15
20
25
30
35
Total Men Women
Kentucky
U.S.
Behavioral Risk Factor Surveillance System, CDC, 2002
Smoking in the Workplace
Worksites with blue collar workers are more likely to have higher prevalence of cigarette smoking than those with white collar workers (Bang & Kim, 2001).
Smoking on the Job
Smoking when combined with workplace chemicals and other toxic agents is particularly harmful.
Nonsmokers exposed to secondhand smoke on the job increase their heart disease and lung cancer risk by 20-30%.
Effects of Secondhand Smoke (SHS)
Those exposed to SHS, at work or at home, have an increased risk of developing asthma.
SHS contributes to the severity and exacerbation of existing asthma among adults.(Jaakkola, 2002)
(SHS) and Heart Disease
Short term exposure (5 min.-2 hrs.) can increase risk of heart attack and stroke.
Affects platelets, endothelium, and heart rate variability (narrowing of blood vessels and clot formation)
Heart disease accounts for about 37,000 of the 53,000 U.S. deaths attributed to involuntary smoking each year. (Glantz & Parmley, 2001)
(SHS) and Lung Cancer
There is a clear dose-response relationship between duration of exposure to SHS and increased lung cancer risk in never smokers.
Those ever exposed to spousal SHS are 18% more likely to get lung cancer; those with long-term exposure are 23% more likely.
Reducing exposure to SHS results in decreased opportunities to smoke, thus reducing active smoking levels
(Brennan, et al., 2004)
Costs of Smoking in the Workplace
A smoking employee costs the employer at least $1,000 MORE in direct and indirect health care costs compared with a similar nonsmoking employee.
SHS can cause burning of the eyes and nose, headaches, and nausea in nonsmokers, affecting their morale and productivity.
Smoking costs the U.S. $75.5 billion in direct health care costs and $81.9 billion in lost productivity costs annually (ALA, 2003).
Benefits of a Smoke-free Workplace
Smoking bans decrease disability and early retirement payments by 75%.
Smoking bans reduce health and fire insurance premiums by over 25%.
Dramatic decreases in maintenance costs.
The Ventilation Lie
No feasible ventilation system can reduce SHS exposure to safe levels
Simply separating smokers and nonsmokers is not effective
The current indoor air standard set by ASHRAE assumes no smoking
Worksite Smoking Bans Help Smokers
Quit
Smoke-free workplaces are associated with a 29% drop in cigarette consumption. Smokers are more likely to make serious quit attempts and achieve cessation (Glasgow, 1997).
Tobacco Policy in Kentucky Manufacturing Facilities, 1999-2002
67
43
40
69
43
74
46
47
33
3226
24
0 20 40 60 80
Have Smoking Policies
Ban Indoor Smoking
Offer Cessation Resources
Reimburse for Cessation 2002 (N = 625)2000 (N = 437)1999 (N = 160)
Percent
Company Characteristics and Smoking Policies (2000)
Companies with a written smoking policy more likely to provide cessation resources than those without a policy
Large companies 2 ½ times more likely to have written smoking policies but more likely to sell cigarettes than small manufacturers
Companies with unions more likely to permit indoor smoking and sell cigarettes, but 5 ½ times more likely to provide cessation resources than those without a union.
Smoking Policies in ALL Worksites in Kentucky, 1999
Over half (56%) of ALL worksites were smoke-free in Kentucky, compared to 43% of manufacturers
Smoke-Free Kentucky Food Service Establishments, 1999-2002
3235
39 40
0
10
20
30
40
50
1999 2000 2001 2002
Per
cen
t
Public Support for Smoke-free Workplaces
Nearly all Americans (95%), both smokers and nonsmokers, support banning or restricting smoking in workplaces.
Workplace Tobacco Policy Interview: Purpose
To collect workplace policy data for planning and monitoring change over time
To lay the groundwork for helping manufacturers with tobacco policy change
To recruit partners for your tobacco prevention and cessation coalition
Elements of the Workplace Tobacco Policy Interview, 2004
Presence of a WRITTEN policy How the policy is communicated Where and when employees are allowed to
smoke How the policy is enforced How violators are handled Existence of cessation resources Presence of nutrition policies
Workplace Tobacco Policy Interviews: Methods in a Nutshell
Recruit Human Resource Managers Phone Interview with Human Resource
Manager &/or Other Administrative Personnel Document data on interview form or online FAX data forms to University of Kentucky Send data forms to UK in mailer provided Follow-up with interested manufacturers
Preparing for the Interview
Use one PINK Disposition Sheet for every company
Use the MASTER COPY of the Interview Guide to make copies
Make only SINGLE-SIDED copies When making copies, be sure not to cut the
BRACKETS off!
Recruiting Manufacturing Facilities
Check list of manufacturers for accuracy Call the company and ask for the Human
Resource Manager Introduce yourself Explain purpose of interview Explain who is being asked to participate Say interview will last 10-15 minutes Explain how information will be used
Conducting the Phone Interview
Choose a convenient time without potential interruption
Verify contact information and list name of person interviewed on PINK Disposition Sheet (not on form)– Name– Phone/FAX/e-mail– Verify name of company
and address
Conduct the Phone Interview
Get complete information…ask clarifying questions if needed
If person being interviewed is uncertain about an answer, complete the interview and ask them to get the information and call them back
You may need to talk with more than one person to get the correct information!
Wait until AFTER the interview to discuss issues or further comments about the questions
Averting Refusals
If hesitant to participate:– “You sound busy….when is a more convenient
time to call?”– “There are no right or wrong answers. We are
just interested in what you are doing, so that we can be more effective in planning our health programs”
– ”The information will be kept confidential. The information will be summarized by health department service area, not by individual manufacturer.”
Proper Phone Etiquette
Find the most convenient time Be sensitive to time constraints Be polite Use nonjudgmental approach
Human Subjects Protections
Voluntary participation Minimize barriers to participation Understanding the benefits of participation Right to withdraw or refuse to answer Confidentiality
– No names or addresses of the interviewees on the actual interview form!
Documentation Issues
Complete ALL questions Use a PEN…DO NOT ERASE Put an “X” through incorrect information and fill
in the correct response Completely fill in all circles and boxes Print legibly Fill in only ONE circle per question unless it
says, “Fill in all that apply”
Documentation Issues
PRINT name of the workplace on every page. Pay attention to SKIP patterns. Fill in the CIRCLE for “Other” in addition to PRINTING
the information for “please specify.” PRINT comments on the top or bottom of the page or
between questions, staying away from the boxes, circles, page identifiers, or page definers.
I you don’t PRINT, all your pages will have to be verified.
Places to print comments:
•Top
•Bottom
•Between questions
•Away from boxes, circles, and page identifiers & definers
Submitting Forms Onlinewww.mc.uky.edu/tobaccopolicy
Online version is similar to the print form. Click on the correct circles to answer and type in
specifications. Type extra comments in the space provided at the end. Most of the front page info and “Time Interview Ended”
are required to submit the survey. Check over the entire form before clicking “submit” to
see that all questions are answered. If you collect the information on a paper version of the
form and then submit online, send the paper forms to UK in the mailer provided.
If you submit online as you conduct the interview, do not send paper copies to UK.
AFTER Each Interview
Check interview form for completeness FAX forms to UK as you complete them
(859-323-1033), unless you submit online. Do not FAX forms in bulk! Do one at a time. Best to use a high-speed FAX machine with
memory, if available. Contact Rob Rasnake (859-323-8539) or
[email protected] if you are having difficulty FAXing the forms or have questions
When ALL Interviews are Complete
When all interviews are completed, mail a copy of the PINK Disposition sheets and any completed interview forms to UK in the mailer provided. If you interview while submitting online, just send pink disposition sheets to UK. Everyone sends Disposition sheets!
Keep a copy of the MANUFACTURER LIST for future contacts…indicate which manufacturers are interested in more information.
Do not keep copies of the interview forms Shred any extra copies of the interview form
Follow-Up Contacts with the Manufacturing Facilities
Send thank you letters. Gather materials on workplace tobacco
policy and tips for employers. Send information packets with cover letter. Follow up with phone contact. Involve coalition partners.
Model Workplace Tobacco Policy
Rationale for Policy (Effects of SHS) Types of Tobacco Product Covered
–Cigarettes, Cigars, Pipes, and Spit When and Where Tobacco Allowed
–Breaks? Lunch?–Exact locations of Designated Areas–Vehicles
How Policy is Communicated How Violators are Handled What Department Provides Cessation Resources To Whom it Applies
–Employees, Visitors, Clients, Contractors
Linking Data to Policy Change
Share data with coalition and manufacturers. Present data at interested worksites. Use data as a media opportunity, if
appropriate. Specify targets using baseline data. Base all policy change suggestions on Best
Practices. Recommend only research-based prevention
and cessation activities.
Manufacturers Expressing Interest in Changing Policy
Although most manufacturers were satisfied with their current policy, many expressed interest in changing policy and asked for assistance.
The opportunity exists to motivate and help with policy change that can then begin to change community norms!
Motivating Workplaces Considering Policy Change
Health effects of SHS justify smoke-free policy Other good reasons include:
– Cuts cleaning and maintenance costs– Improves employee morale– Provides an incentive to stop smoking– Providing cessation resources demonstrates the
manufacturer’s commitment to employees Reinforcement of non-smoking norm helps the
community by increasing public awareness of the dangers of smoking (Evans, 1999).
Employer Action Steps (CDC, 2003)http://www.cdc.gov/tobacco/ETS_Toolkit/worksites /employer.htm
1. Plan your approach Designate key staff person to study, plan and
propose the policy Communicate SHS info to influential personnel
from key areas (smokers and non-smokers) Consult with union, if applicable Take a sympathetic approach to smokers and offer
cessation help Focus on Secondhand Smoke (SHS), not smokers
Employer Action Steps
2. Gather facts and information on: SHS Costs and consequences (business, health,
liability) Benefits of going smoke free Support for smokers, including cessation
resources and insurance coverage for cessation Model Policy
Employer Action Steps
3. Assess readiness Conduct survey to help tailor efforts and plan
education, policy and enforcement mechanisms.
4. Educate Take into account organizational readiness and
level of knowledge
Employer Action Steps
5. Implement the plan Complete implementation is key; incomplete
implementation leads to confusion. Give 4 weeks notice Emphasize protection of employee’s health Distribute the complete policy, with a letter from
the CEO Post signs at all entrances and stairwells Conduct awareness programs and distribute
materials clearly describing all procedures
Employer Action Steps
6. Enforce the policyBe fair and equitableGive all new employees written information on
the policy to read and sign