A Comprehensive Approach to

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A Comprehensive Approach to

• Smoking Cessation in the Workplace

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• Smoking and Human Health
• Smoking An Addiction to Nicotine
• Why Consider Stopping Smoking?
• Why Should Unions Support Stop Smoking Programs
  in the Workplace?
• What Supports Can be Provided in the Workplace
  and What is Ideal?
• How Can Unions Support and Promote Stop Smoking
  Programs in the Workplace?

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Background Rationale
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Background Rationale

• Cessation therapy and counselling is the most
  cost effective health intervention that an
  employer can provide.
• Data on the impact of smoking on workplace health
  and productivity was limited.
• Nicotine therapies were initially seen as magic
  bulletsto smoking cessation.
• Access and evidence to support cessationcounselli
  ng were not available.
• The effect of smoking on workplacehealth and
  productivity is currentlywell documented.

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Smoking and Human Health
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Smoking and Human Health

• Canada has no choice but to adopt a new model of
  health care, a business model that encompasses
  both preventing and managing chronic disease.
  (Conference Board of Canada)
• Smoking is a major contributor to several chronic
  diseases
• Cardiovascular disease, including stroke, heart
  attack, etc.
• Cancer
• Emphysema/chronic obstructive pulmonary disease
• Diabetes
• Smoking affects every system in the body

Smoke goes where blood flows!
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Smoking and Human Health

• Tobacco Users are
• Six and a half times more likely to die from lung
  cancerthan non-smokers
• At double the risk for a stroke
• At three times the risk to die from heart attack,
  than non-smokers
• In Canada, smoking accounts for a large
  percentage of deaths
• 87 of lung cancer deaths lung cancer is the
  leading cause of cancer deaths for both Canadian
  men and women
• 30 of all cancer deaths
• 21 of all coronary heart disease deaths
• 10 of all infant deaths

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Smoking Rates by Occupation in Canada
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Smoking and Human Health

• Tobacco is the only legally available consumer
  product which kills people when used entirely as
  intended.
• World Health Organization

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Smoking An Addiction to Nicotine
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Nicotine Withdrawal

• 800 am - Had a cigarette
• 1000 am - Experiencing withdrawal
• 1200 pm - Reaching peak withdrawal

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PHYSICAL
EMOTIONAL
PSYCHOLOGICAL
BEHAVIOURAL
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Smoking Cessation Myths and Misconceptions

• Most smokers do not want to stop smoking
• FALSE! 91 of people who smoke have at least some
  desire to quit smoking and over half are
  seriously considering quitting within the next 6
  months
• You just need willpower to stop smoking
• FALSE! Nicotine addiction is a complex addiction
  (a chronic relapsing condition). Supports, such
  as counselling and medication, are effective
  tools to help stop smoking

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Smoking Cessation Myths and Misconceptions

• Stopping smoking is a one time event
• FALSE! It takes an average of 4-5 attempts to
  stop completely. Each stop attempt has proven
  health benefits
• If you relapse, youve failed at your attempt to
  stop smoking
• FALSE! Stopping smoking is a process, not an
  event. Each attempt should be considered a
  success and the employer should never stop
  supporting the process

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Smoking Cessation Myths and Misconceptions

• Stop smoking programs only benefits the smoker
• FALSE! Non-smokers who work in smoke
  filled/exposed environments inhale the same 4000
  toxic and carcinogenic chemicals as smokers.
  Cigarettes produce 12 minutes of smoke, and the
  smoker inhales only 30 seconds of smoke. The rest
  lingers in the air and affects all who are
  exposed

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Why Should Union Members Consider Stop Smoking
Programs?
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Blood pressure pulse return to normal
Risk of heart attack begin to decrease
20 Minutes
8Hours
24 Hours
48 Hours
Oxygen levels return to normal
Sense of taste smell improve
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Improvements in lung function and circulation
Risk of heart disease is reduced by 1/2
Risk of lung cancer is reduced by 1/2
1Year
10 Years
9 Months
5Years
15 Years
2 Weeks
Lungs improve capacity to clear reduce infection
Risk of stroke is reduced
Risk of heart disease is similar to a person who
never smoked
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Stop Smoking SupportCost Savings
Based on1 pack per day,10 per pack
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Stop Smoking SupportCost Savings
Half a year of groceries
1 family trip down south
146 DVDs
With the money saved after 1 year
50 plasma big screen TV
122 tanks of gas
Half semester of tuition
12 ipods
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Why Should Unions Support Stop Smoking Programs
in the Workplace?
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Why Help?

• Unions can be a champion in promoting and
  advocating for the health of its members (smokers
  and non-smokers alike)
• Stop smoking programs could be one of the most
  effective supports
• Member smoking affects union contract
  negotiations as employers seek to offset the
  costs associated with smoking(e.g., sick days,
  insurance)

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Why Help?

• Smoking Cessation is Challenging
• Many union members face work stresses and use
  nicotine to cope
• Workplaces that permit smoking on site makes
  stopping smoking especially difficult
• Some members hold multiple jobs, do shift work,
  or have transportation challenges and therefore
  can only access stop smoking support when held
  on-site, during multiple shifts or via telephone
• Second hand smoke can causes health risks for
  non-smoking members

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Impact on Members
Increased Insurance Premiums
Poor Health
Smoking Union Member
Less Disposable Income(used on cigarettes)
Social Stigma
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What Supports can be Provided in the Workplace
andWhat is Ideal?
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Range of Smoking Cessation Programs/Supports

• Comprehensive (greatest impact!)
• Offering programs, supports and activities at the
  workplace(on-site, during work hours, etc.)
• Facilitated
• Working with outside agencies to
  deliverprograms, supports and activities
  off-siteand providing self-help materials
• Education Information
• Provision of educational self-help materials

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Success
Without support, smoking cessation is challenging
for employees.
Only 2.5-5 of smokers who attempt to quit
unaided will succeed
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Success
The provision of workplace support will empower
employees to work towards reaching their
cessation goals.
Smoking cessation medication tripleslong-term
success
NRT doubleslong-term success
Compared to no support, face-to-face counselling
increases success
Telephone counselling one session face-to-face
counselling increases success
Medication and intense face-to-face counselling
increases success
Telephone counselling medication increases
success
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Supporting Smoking Cessation

• Smokers are 2-3 times more likely to succeed with
  supportthan without
• Stop smoking rates increase when a workplace
  smoke free policy (restriction) is implemented
• Over 26 of the smokers who wereprohibited from
  smoking at work hadstopped smoking in the past 6
  months,compared to 19 without ano smoking
  policy

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A Comprehensive ApproachConsiderations
Cost

• There should be no cost to the employee to
  participate, and medications/nicotine replacement
  therapy should be subsidized

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A Comprehensive ApproachConsiderations
Accessibility

• Program should be accessible
• Offered on-site /made available across multiple
  sites
• Offered during work hours (not in lieu of normal
  breaks)
• Provide a range of supports - Smokers Helpline,
  one-on-one counselling, group counselling, etc.

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A Comprehensive ApproachConsiderations
Accessibility

• Smokers Helpline free, confidential telephone
  support, tips, tools and advice from trained
  Quit Specialists
• NS, NB, PEI - 1-877-513-5333www.smokershelpline.c
  a
• NL - 1-800-363-5864 www.smokershelp.net

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A Comprehensive ApproachConsiderations
Tailoring

• The provision of cessation supports should align
  with what your company can feasibly support
  (within its capacity)
• Consider How many employees smoke employee
  interest in stopping smoking how employees
  prefer to engage in cessation employee
  expectations around workplace stop smoking
  supports gauge employee interest in using the
  types of supports the employer plans to offer

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Program SuccessRepresentation Engagement of
Key Stakeholders

• Engage stakeholders at all stages
• Provide a voice to all workplace parties
• Supported by management, but not management
  driven
• A committee could be formed to representunion
  management, union members, etc.

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Program SuccessPromotion

• The program needs to be effectively promoted to
  generate interest encourage participation among
  employees
• Employees should have the opportunity to provide
  feedback on program success and potential areas
  for improvement

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How Can Unions Support Promote Stop Smoking
Programs in the Workplace?
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Smoke Free Worksites / Workplaces

• Unions can lead in
• Negotiating for a formal written
  no-smokingpolicy if none exist at worksites
• Negotiating to strengthen an existing no-smoking
  policy
• Adopting resolutions in support of smoke-free
  workplace policies

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Health Benefits

• Unions can lead in
• Negotiating for comprehensive stop
  smokingtherapy in member health benefits
• Negotiating for improved coverage
• Subsidize nicotine replacement therapyand
  cessation medication drug coverage
• Eliminating lifetime maximum coverage
• Improving access to counselling support
• Group counselling
• One-on-one counselling
• Smokers Helpline

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Member Needs

• Unions can lead in
• Working with managementand other key
  stakeholdersto ensure the needs ofmembers are
  met

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Promotion

• Unions can lead in
• The promotion of the benefitsof the program to
  its members

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Summary

• Areas in which unions can lead and support its
  members in stopping smoking
• Smoke-free worksites/workplaces
• Negotiating for comprehensive smoking cessation
  health benefits
• Understanding and advocating for the needs of
  members around stop smoking support
• Promotion of stop smoking programs

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Thank You
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References

1. Canadian Cancer Society (2008). Effective
   Workplace Tobacco Cessation Interventions
2. Canadian Cancer Society (2008). Tobacco
   Statistics in Canada Health Canada (2007).
   Smoking Diseases. Health Effects of Smoking.
3. Canadian Cancer Society (2008). Second Hand Smoke
   is Dangerous.
4. Canadian Lung Association. Making Quit Happen.
5. Conference Board of Canada (2008). How Canada
   Performs A Report Card on Canada Health Overview
6. Conference Board of Canada (2006). Smoking and
   the Bottom Line Updating the Costs of Smoking in
   the Workplace
7. Health Canada (2008). Smoking Cessation in the
   Workplace- A Guide to Helping your Employees Quit
   
8. Health Canada (2008). Second-hand Smoke.

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References

1. Health Canada (2008). Smoking and Your Body-
   Health Effects of Smoking
2. Health Canada (2007). Rewards of Quitting
3. Health Canada (2007). Towards a Healthier
   Workplace A Guidebook on Tobacco Control
   Policies.
4. Health Canada (2003). Canadian Tobacco Use
   Monitoring Survey. Moskowitz, J.M., Lin, Z. and
   Hudes, E.S (2000). The impact of workplace
   smoking ordinances in California on smoking
   cessation. American Journal of Public Health
5. New Zealand Ministry of Health (2007). New
   Zealand Smoking Cessation Guidelines.
6. Rehm, J. et al. (2006). The cost of substance
   abuse in Canada, 2002. Canadian Centre on
   Substance Abuse
7. World Health Organization (2003). An
   international Treaty for Tobacco Control.

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