Smoke-free Workplace

Background

Secondhand tobacco smoke is a combination of smoke exhaled by the smoker (mainstream smoke) and the smoke that comes from the burning end of a cigarette, cigar or pipe (side stream smoke) (8). Secondhand tobacco smoke is a well-established health hazard that causes lung cancer, heart disease, and respiratory ailments, as well as other health problems (11). Tobacco is responsible for over 400,000 deaths in the United States annually, of which 53,000 are the result of secondhand smoke exposure (10,11,15).  The 2002 Environmental Health Information Service's 10th Report on Carcinogens classifies secondhand smoke as a Group A (Human) Carcinogen, which is a substance known to cause cancer in humans. There is no safe level of exposure for Group A toxins (16).
 
The workplace can be a significant source of secondhand smoke exposure. One study found that nonsmoking employees exposed to secondhand smoke at work, but not at home, had significantly higher levels of nicotine metabolite in their blood than did nonsmoking workers with no work or home exposure to secondhand smoke (12). Exposure also varies substantially by industry and occupation. For example, in a recent study, waiters were found to have the highest exposure to secondhand smoke of several occupations observed, while rates were lowest among farm and nursery workers (19). Workers in restaurants, bars, casinos, billiard halls, and other hospitality venues are typically at high risk for secondhand smoke exposure (14) (For more information, please see the following policy profiles: Smoke-Free Bars and Smoke-Free Restaurants). 

One Healthy People 2010 objective is to increase the proportion of worksites with formal policies that prohibit smoking, in order to reduce exposure. Many businesses have already taken steps to eliminate or reduce workplace secondhand smoke exposure. As of 1999, according to Current Population Survey data, 68.6% of indoor workers aged 15 years and older nationally were covered by smoke-free workplace policies. In some states, such as Maryland and Utah, over 80% of workers were covered by such policies (13).

A significant incentive for creating smoke-free workplaces is the reduction of employer costs. Direct and indirect costs of employees who smoke include decreased productivity, increased illness and absenteeism, higher healthcare and insurance costs, and increased workers' compensation payments and occupational health awards. Other costs include property damage, accidental fires and additional cleaning and maintenance costs (7).

Policies

Pass local ordinance or state law mandating smoke-free private work places.

Policy makers can protect all employees from dangerous exposure to secondhand smoke at work by requiring all worksites in their jurisdictions to be smoke-free. A Healthy People 2010 objective states that jurisdictions should establish laws on smoke-free indoor air that prohibit smoking, or limit smoking to separately ventilated areas (15).
 
According to the American Lung Association, as of 2004, 27 states have laws in place restricting smoking in private work places (1). Of these, five states – California, Connecticut, Delaware, Maine, and New York – meet the Healthy People 2010 objectives for comprehensive state laws covering public places and worksites. One example of such a law is the California Smoke-free Workplace Law (Labor Code Section 6404.5), which prohibits smoking in restaurants and bars in all 536 municipalities in the state (3). To learn more about specific state laws visit http://slati.lungusa.org/.
 
 In addition to states that have passed smoke-free indoor air policies, according to the American Nonsmokers' Rights Foundation, as of April 2004, 224 municipalities had local clean indoor air ordinances that required workplaces to be 100% smoke-free (3). Of these 80 had local 100% smoke-free laws in all workplaces, restaurants, and bars. The number of municipalities with 100% smoke-free laws has increased substantially over the last 10 years. In 1993, Davis, CA was the only county in the United States with a 100% smoke-free law. By 2001, there were 56 municipalities with such laws, and by 2003, there were 79 (2).
 
 
Employers implement a smoke-free workplace.

To protect all employees from the health hazards associated with secondhand smoke exposure, companies can implement a smoke-free workplace policy. Public support for smoke-free policies increased during the 1990s as the public became more aware of the risks associated with exposure to secondhand smoke. For the 1998-1999 Current Population Survey data, 65% of respondents nationally stated that smoking should not be allowed at all in indoor work areas (9). Recent trends among some employers, particularly employers with a health-related mission, include implementing smoke free campus policies.
 
 

• Lowe's Companies Inc. has a smoke-free campus policy at each of the company's corporate campuses in Mooresville and Wilkesboro, North Carolina, and at all of the company's over 900 home improvement stories in 45 states (18).

 

• USAA, a company that produces financial products, services, and insurance for members of the U.S. military and their families, has a smoke-free workplace policy that applies to all 9,248 employees in San Antonio, Texas and at several other locations throughout the United States and Europe (18).

 

• Vistakon in Florida implemented a smoke-free workplace, and at the same time offered employees who smoke appropriate smoking cessation resources upon request (7).

 
 
Pass local ordinance or state law mandating smoke-free government worksites.

Government agencies have taken the lead on mandating smoke-free workplaces. According to the American Lung Association, 46 states have laws in place that restrict smoking in state government worksites. Of these, 32 limit smoking to designated areas, two require either no smoking or designated smoking areas with separate ventilation, and 12 completely prohibit smoking (1).

Effectiveness Data

  According to the Centers for Disease Control and Prevention's Guide to Community Preventive Services, reductions in secondhand smoke exposure generally were greater in workplaces that had smoking bans than in those only with smoking restrictions (6). A recent study showed that within the hospitality industry, in locations such as social and gaming clubs, the use of designated "no smoking" areas did not substantially improve the quality of air in such areas. In fact, the amount of atmospheric nicotine was around half of that in the designated smoking areas, and the particulate matter levels were higher than those outside of the establishment. The authors of the study concluded that while designated smoking areas may confer some protection from secondhand smoke, the effect is minimal and not as great as in establishments that are completely smoke-free (4).

In 1999, on average, each adult smoker cost employers $1,800 in lost productivity and $1,600 in medical expenditures. Absentee rates among smokers were also two to four days higher than for non-smokers (5). Therefore, a smoke-free workplace can enhance productivity by reducing excess smoking-related absenteeism and reduce insurance costs among smokers who quit smoking as a result of the smoke-free policy (7). Several studies have also found that smoke-free workplace policies also lead to increased cessation among employees and reduced cigarette consumption among those employees who continue to smoke (6). 

Resources

 
Americans for Nonsmokers' Rights
2530 San Pablo Avenue, Suite J
Berkeley, CA 94702
Phone: 510-841-3045
Website: http://www.no-smoke.org/

BREATH - The California Smoke-Free Bar Program
5495 Carlson Drive, Suite D
Sacramento, California, 95819
Phone: (916) 739-8925 
Web site: http://www.breath-ala.org


California Tobacco Control Alliance
980 9th Street, Suite 370
Sacramento, CA 95814
Phone: (916) 554-0390
http://www.tobaccofreealliance.org/
 
Tobacco Control Policy and Legal Resource Center
New Jersey Group Against Smoking Pollution (GASP)
105 Mountain Avenue
Summit, NJ 07901
Phone: 908-273-3171

References

 
 

1. American Lung Association. (2004). State Legislated Action on Tobacco Issues (SLATI). Available online at: http://slati.lungusa.org/

 

2. American Nonsmokers' Rights Foundation. (2004, April). Local 100% Smokefree Laws in all Workplaces, Restaurants, and Bars: Enactment by Year. Available online at: http://www.no-smoke.org

 

3. Americans Nonsmokers' Rights Foundation. (2004, April). Municipalities with 100% Smoke free Ordinances. Available online at http://www.no-smoke.org/100ordlisttabs.pdf

 

4. Cains, et. al. (2004). Designated no smoking areas provide from partial to no protection from environmental tobacco smoke. Tobacco Control, 13(1): 17-22.

 

5. Centers for Disease Control and Prevention. (2002). Coverage for Tobacco Use Cessation Treatments. Available online at: www.cdc.gov/tobacco/educational/materials/cessation

 

6. Centers for Disease Control and Prevention. (2001). Guide to Community Preventive Services - Effectiveness of Smoking Bans and Restrictions to Reduce Exposure to Environmental Tobacco Smoke. Available online at: http://www.thecommunityguide.org/tobacco/tobac-int-smoke-bans.pdf

 

7. Centers for Disease Control and Prevention. (1994). Making Your Workplace Smoke-free:  A Decision Maker's Guide. Available online at: http://www.cdc.gov/tobacco/research_data/environmental/etsguide.htm

 

8. Centers for Disease Control and Prevention. (2004, February). Secondhand Smoke - Fact Sheet. Available online at: www.cdc.gov/tobacco/factsheets/secondhand_smoke_factsheet.htm

 

9. Gilpin, E., Lee, L., Pierce, J. (2004). Population attitudes about where smoking should not be allowed: California versus the rest of the United States. Tobacco Control, 13(1):38-44.

 

10. Glantz, S. & Parmley, W. (1991). Passive Smoking and Health Disease: Epidemiology, Physiology, and Biochemistry. Circulation, 83(1):1-12.

 

11. National Cancer Institute. (1999). Health Effects of Exposure to Environmental Tobacco Smoke: The Report of the California Environmental Protection Agency. Smoking and Tobacco Control Monograph, 10. Available at: http://cancercontrol.cancer.gov/tcrb/monographs/10

 

12. Pirkle. J, et al. (1996). Exposure of the US Population to Environmental Tobacco Smoke: The Third National Health and Nutrition Examination Survey, 1988-1991. Journal of the American Medical Association. 275: 1233-1240.

 

13. Shopland, D., Gerlach, K., Burns, D., Hartman, A., Gibson, J. (2001). State Specific Trends in Smoke-Free Workplace Policy Coverage, 1993-1999. Journal of Occupational Environmental Medicine, 43:680-686.

 

14. Siegel, M & Skeer, M. (2003). Exposure to secondhand smoke and excess lung cancer mortality risk among workers in the "5 Bs": bars, bowling alleys, billiard halls, betting establishments, and bingo parlours. Tobacco Control, 12:333-338. Abstract available online at: http://tc.bmjjournals.com/cgi/content/abstract/12/3/333

 

15. US Department of Health and Human Services. (2000). Healthy People 2010. 2nd ed. Washington, D.C.: U.S. Government Printing Office.

 

16. US Department of Health and Human Services, Public Health Service, National Toxicology Program. (2002 December). Report on Carcinogens, Tenth Edition. Washington, DC: US Government Printing Office.

 

17. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (1992) Survey of Worksite Health Promotion Activities. Washington DC: US Government Printing Office.

 

18. Vaughn, Glenda, Public Health Analyst, Office on Smoking and Health, Centers for Disease Control and Prevention. Communication with the Center for Health Improvement May, 2004.

 

19. Wortley, P., Caraballo, R., Pederson, L., Pechacek, T. (2002) Exposure to secondhand smoke in the workplace: serum cotinine by occupation. Journal of Occupational Environmental Medicine. 44(6):503-509.

 

Acknowledgements

Dana Shelton, MPH, Associate Director, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
 
Glenda Vaughn, Public Health Analyst, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA
 
Traci Verardo, Executive Director, California Tobacco Control Alliance, Sacramento, CA
 
 
 
The Center for Health Improvement also acknowledges the following reviewers for providing comments on the original version of this policy profile:
 
Michael P. Eriksen, Sc.D., Former Director, Office of Smoking on Health, Centers for Disease Control, Atlanta, GA

David Fleming, M.D., Former State Epidemiologist, Oregon Health Division, Portland, OR

Sally Herndon-Malek, Former Director, Project ASSIST, DHHS, Raleigh, NC

Philip Huang, M.D., M.P.H., Chief, Bureau for Disease and Injury Prevention, Texas Department of Health, Austin, TX

Kevin Keane, Director, Federal Legislative Advocacy, American Cancer Society, California Division, Sacramento, CA

Jon Lloyd, Director, Tobacco Control Program, Planning and Policy, California Department of Health Services, Sacramento, CA

Paul Minicucci, Former Executive Director, California Next Generation Tobacco Control Alliance, Sacramento, CA

Jane Pritzl, Former Field Director, Assist Project, Division of Prevention Programs, Colorado Department of Public Health and Environment, Colorado, UT

Randy Schwartz, American Cancer Society, New England
 
Updated 6/30/04