Smokers in the Workplace Study:
A Survey of Employers and Employees
National Business Group on Health
November 2006
In November 2006, the National Business Group on Health conducted an online survey of its members. This survey was part of an educational initiative sponsored by Pfizer Inc. The survey polled two audiences: employers and employees. The employer component included 508 benefits decision-influencers from companies with 500 or more employees that offer health benefits. The employee component included 510 full-time employed smokers who work for companies (with 500 or more employees) that offer health benefits. The survey explored:
- Employers' understanding, beliefs and actions about tobacco use, nicotine addiction, and smoking cessation practices and benefits.
- Employees' understanding, beliefs and actions about tobacco use, nicotine addiction, and smoking cessation practices and benefits.
The Centers for Disease Control and Prevention (CDC) and the Agency for Healthcare Research and Quality (AHRQ) recommend that a company include all of the following components in its smoking cessation benefit:
- Cover at least four counseling sessions of at least 30 minutes each, including telephone and individual counseling sessions.
- Cover smoking cessation prescription medications.
- Cover over-the-counter nicotine replacement medication.
- Provide counseling and medication coverage for at least two smoking cessation attempts per year.
- Eliminate or minimize co-pays or deductibles for counseling and medications.
Survey Results
Feelings on Employee Smoking and Workplace Support
Almost all (97%) of employees know that smoking cigarettes can cause a multitude of diseases and conditions.
20% of employees say they are extremely or very motivated to quit smoking:
- 88% have tried to quit smoking.
- 25% have made more than five quit attempts in their lifetimes.
Top two factors employees feel would help them quit smoking:
- 60% Treating cravings
- 52% Fighting withdrawal symptoms
Most employees (86%) and employers (86%) believe that smoking is a treatable condition. However, sense of responsibility varies among the two groups:
- 43% of employers believe that employers have a responsibility for helping smokers quit, compared to 10% of employees.
- 82% of employers agree that "employers should take steps to help their employees stop smoking," while only 52% of employees agree.
Employers see themselves as more supportive than employees do:
- 24% of employees believe their employers have been highly supportive in helping employees to quit smoking, compared with 43% of employers who believe they've been highly supportive.
Smoke-free Workplace Policy
Employer reasons for instituting a smoke-free workplace policy:
- 73% of employers believe that establishing a smoke-free workplace policy is the most valuable way for an employer to encourage smokers to quit or reduce smoking.
- 66% of employers believe that offering smoking cessation benefits has a greater value. The CDC states that providing smoking cessation benefits is the number one cost-effective benefit employers can provide.
Employers have encouraged smoking cessation by:
- 67% of employers have established smoke-free workplaces to encourage employees to quit smoking.
- 40% of employers have offered their employees smoking cessation benefits.
- 9% of employers have required higher premiums from smokers.
Perceptions on the effectiveness of a smoke-free workplace policy:
- 25% of employers say their smoke-free workplace policy has been effective at motivating employees to quit or reduce smoking,
- Only 6% of employees agree that is has been effective at motivating them personally.
- 1% of employees have quit smoking and 14% have tried to quit smoking because of their employer's smoke-free workplace policy, while 44% have found alternate places to smoke during the workday.
On average, employees who take smoking breaks spend 7 minutes per workday smoking cigarettes. This translates to 30 hours per year, or almost a full week for some.
Smoking Cessation Benefits – The Decision
Offering smoking cessation benefits is the top action employees without smoking cessation benefits wish their employers would take to help them quit smoking. However, only 3% of employees without benefits have ever addressed this need with their employers.
Almost half (46%) of employers say their companies offer smoking cessation benefits, while only 16% of employees say they do.
Top factors influencing companies' decisions to add new benefit options:
- 70% Rising healthcare costs.
- 62% Desire for a healthy workforce.
- 52% Attracting/retaining new employees.
70% of employers reported that decreasing health insurance costs was the number one goal for offering smoking cessation benefits. However, only 26% of employers measure the higher costs associated with offering smokers health insurance coverage.
Employer reasons for not offering smoking cessation benefits:
- 36% Lack of demand from employees.
- 31% Never even considered it.
- 30% Cost is too high.
24% of employers who do not currently offer smoking cessation benefits reported that they are:
- Either extremely or very likely to offer them in the next couple of years; 43% of these employers reported they are somewhat likely to do so.
Only 17% of employers know the CDC guidelines for smoking cessation benefits.
Smoking Cessation Benefits – The Components
Top three smoking cessation benefits used by employees with smoking cessation benefits:
- 19% Over the counter therapies
- 12% Prescription medicines
- 7% Individual counseling
47% of employers with smoking cessation benefits offer two or more quit attempts as part of their package (as recommended by the CDC).
Among employees without smoking cessation benefits, coverage for medications is the most desired component of smoking cessation benefits packages (desired by 46%).
Smoking Cessation Benefits – Communications
Both employers and employees report that benefits materials packages is the top way employers communicate their smoking cessation resources. Other methods include:
- Employee newsletters
- Human resources presentations
- Company website
- Brochures
25% of employees with smoking cessation benefits do not know what's covered.
78% of employees with smoking cessation benefits do not know how many quit attempts are covered.
Smoking Cessation Benefits – Outcomes
28% of employers believe their current smoking cessation benefits are highly effective in motivating employees to quit smoking.
10% of employees with smoking cessation benefits think their current benefits are highly effective at motivating them personally.
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