Include Diverse Tobacco Products in Smoking Cessation Programs, Experts Advise

Nancy Grover

Sarasota, FL ( – Employers pay substantially more for their workers who smoke compared to those who don’t — in lost productivity, health issues, exacerbated severity of occupational disease and injury, and an increased risk of injury and property loss. The National Institute of Occupational Safety and Health has estimated smokers cost employers an average of nearly $6,000 each year compared to non-smokers.

New research shows that the use of e-cigarettes by employees may present even more problems, as many who do so also use additional forms of tobacco. Researchers and health authorities say workplace-based efforts to help employees quit tobacco use can be easily integrated into occupational health and wellness programs. Doing so, they say, will protect employees’ health and be financially beneficial to workers and employers.

E-Cigarette Update

Use of e-cigarettes among workers has increased in recent years. A new study estimated that 5.3 million U.S. workers, or 3.4 percent of the workforce used them during the 2017-2018 period. They are especially prevalent among non-Hispanic white males between the ages of 18 – 24, and workers in the accommodation and food services industry and in food preparation and serving related occupations. There has also been an increased use of e-cigarettes seen among workers in public administration, protective services, transportation and material moving, and sales and related occupations.

In a recent study published by the Centers for Disease Control and Prevention, researchers analyzed responses from nearly 35,000 adults who were “working at a job or business,” “with a job or business but not at work,” or “working, but not for pay, at a family-owned job or business” during the week before the interview.

Those more likely to use e-cigarettes had a high school education or less, family incomes of less than $35,000 with no health insurance and with self-reported poor or fair physical health. Additionally, they were more likely to use other tobacco products. “The prevalence of e-cigarette use was 10.9% among current cigarette smokers, 6.8% among former smokers, 10.4% among users of other combustible tobacco, and 7.3% among smokeless tobacco users,” the researchers wrote. “Approximately one half of workers who currently use e-cigarettes also smoke combustible tobacco products, with the percentage varying by sociodemographic characteristics, industry, and occupation.”

Many adults say they use e-cigarettes as a way to quit smoking. While these may be an effective substitute, there is not enough evidence to conclude e-cigarettes help smoking cessation.

“Moreover, many adult e-cigarette users do not stop smoking cigarettes and instead continue to use both products,” the researchers wrote. “Smoking even a few cigarettes per day has health risks, and the use of cigarettes in combination with e-cigarettes is associated with the same, or in some cases higher, exposure to known tobacco-related toxicants compared with using cigarettes alone.”

How to Help

Targeted, evidence-based programs to help control tobacco use should address the diversity of products used, the researchers suggested. These should be integrated into workplace health promotion programs.

One way to help is by educating employees on the benefits of tobacco cessation, not only on their health but their finances as well. “Among other savings, they no longer incur direct costs associated with consumer purchases of tobacco products and related materials, and they generally pay lower life and health insurance premiums and lower out-of-pocket costs for health care,” the study says.

Employers who may be hesitant to offer such programs may be more inclined to do so once they realize the benefits to their organizations by helping workers cease tobacco use.

“Not only are nonsmoking workers generally healthier, but they are more productive and less costly for employers,” the authors wrote. “It follows that interventions that help smoking workers quit can benefit the bottom line of a business.”

Asking a worker about his tobacco use and offering brief counseling is one suggestion. These workers can also be referred to publicly funded state quitlines, which have been shown to be effective.

“Mobile phone texting interventions and web-based interventions are also promising approaches to assist with tobacco cessation,” according to NIOSH.

NIOSH suggests that at a minimum, employers establish and maintain smoke-free workplaces that protect those in workplaces from involuntary, secondhand exposures to tobacco smoke and airborne emissions from e-cigarettes and other electronic nicotine delivery systems. Establishing and maintaining “entirely tobacco-free workplaces, allowing no use of any tobacco products across the entire workplace campus,” is also recommended.

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