Likewise in the United Kingdom From to prevalence in the United States fell at about 0. Our results for consumption per smoker 3. They did not quantify effects on prevalence. To protect the health of non-smokers US local and state governments have enforced legislation restricting smoking in public and in workplaces. Seven studies reported the effects of these laws on adult consumption or prevalence.
Local clean air laws are stronger and more comprehensive than state legislation. Teenagers respond to smoke-free environments by decreasing smoking.
One study reported the effects of workplace policies on employed teenagers. Eight studies examined the effect of state and local clean air laws on smoking in young people.
Voluntary action to make homes smoke-free leads to lower rates of smoking among US high school students odds ratio 0. As interventions designed to restrict the purchase of cigarettes have no effect on the prevalence of smoking among teenagers, clean indoor air is an effective strategy for reducing tobacco consumption among teenagers. We included studies with different methods carried out in different settings at different points in time. There were, however, no systematic differences in the results obtained in the workplace and population based studies, and the random effects model in the meta-analysis allows for any heterogeneity in study design.
We used changes in consumption per continuing smoker to measure the effect of the policies on consumption. Eight of the studies, however, reported consumption per current smoker that is, including in the baseline measurement people who quit after the policy was implemented and in the follow up those who started after the policy. We may therefore be underestimating the effect on continuing smokers. If all workplaces that are currently not smoke-free in the United States and the United Kingdom were to become smoke-free, consumption per capita for the entire adult population would drop by 4.
While producing benefits for non-smokers by eliminating passive smoking 32 , 57 , , and making it easier for smokers to reduce or stop smoking, smoke-free workplaces substantially reduce tobacco industry sales.
This loss in revenues explains why the industry fights so hard against legislation to ensure that workplaces become smoke-free. Editorial by West. Competing interests: None declared. National Center for Biotechnology Information , U.
Journal List BMJ v. Author information Article notes Copyright and License information Disclaimer. Correspondence to: S A Glantz ude. Accepted Mar This article has been cited by other articles in PMC. Abstract Objective To quantify the effects of smoke-free workplaces on smoking in employees and compare these effects to those achieved through tax increases. Design Systematic review with a random effects meta-analysis. Study selection 26 studies on the effects of smoke-free workplaces.
Participants Employees in unrestricted and totally smoke-free workplaces. Main outcome measures Daily cigarette consumption per smoker and per employee and smoking prevalence. Results Totally smoke-free workplaces are associated with reductions in prevalence of smoking of 3. Conclusions Smoke-free workplaces not only protect non-smokers from the dangers of passive smoking, they also encourage smokers to quit or to reduce consumption.
What is already known on this topic Smoke-free workplaces are associated with lower cigarette consumption per continuing smoker.
Introduction Passive smoking is linked with cancer, heart disease, respiratory illness 1 , 2 and is the leading source of indoor air pollution. Methods Study selection We located studies on the effects of totally smoke-free workplaces on prevalence of smoking and daily cigarette consumption through Medline, Science Citation Index, Social Sciences Citation Index, Current Contents, and PsychInfo; from reviews 6 , 21 , 23 , 24 ; and from references in the papers we located.
Data analysis We computed differences in consumption per smoker and per employee and prevalence before and after workplaces became smoke-free in workplace studies or between comparable samples with and without regulations in population studies.
Open in a separate window. Results Effects of smoke-free workplaces Implementation of totally smoke-free workplace policies was associated with a reduction in absolute prevalence of 3. NR: Not reported. Effects of legislation To protect the health of non-smokers US local and state governments have enforced legislation restricting smoking in public and in workplaces.
Effects of smoke-free workplaces and clean air legislation on teenagers Teenagers respond to smoke-free environments by decreasing smoking. Weaknesses of study We included studies with different methods carried out in different settings at different points in time.
The complete description of the methodological assumptions has been published elsewhere [ 22 ]. Briefly, the survey was designed to generate precise cross-sectional estimates at the national level. The final probability selection of the sample units was equivalent to that of being selected under the three-stage stratified-cluster sampling in order to produce key indicators by gender, for the country as a whole as well as classified by residence urban or rural , and to allow for comparison of the estimates among the 6 geopolitical zones of Nigeria.
Following the GATS sampling protocol, a sample of at least 8, respondents was required with 4, adults each from urban and rural areas. The household sample size was then adjusted to account for the potential sample size loss due to ineligibility and nonresponse.
A total of 11, households were sampled, of which 5, were from urban areas and 5, were from rural areas. One eligible household member was randomly selected from each participating household, which resulted in 9, individuals completing the survey. GATS Nigeria included a household questionnaire and an individual questionnaire. The questionnaires were applied during face to face interviews with the persons who were 15 years of age or older and they were recorded on an electronic data collection device.
The household response rate was Current analysis is restricted to the GATS respondents working indoors or both indoors and outdoors but outside their home participants. If the study subjects indicated current smoking on a daily or less than a daily basis they were considered smokers.
Similar classification was considered for smokeless tobacco use yes, if the participant indicated usage of these products daily or occasionally. Initially, a descriptive analysis for all the variables involved in the analysis was completed.
The logistic regression model was adjusted for all the covariates significant at a 0. Age and number of household members were treated as continuous variables. We tested for multicollinearity for covariates that were controlled for in the analysis. The multicollinearity diagnostics variance inflation factors VIF were all less than five, which indicates that the assumption of reasonable independence among predictor variables was met.
Most of the study subjects who worked indoors but out of their homes were younger than 45 Table 1. Males constituted Similar percentages of the study participants lived in urban areas. Among the self-employed nonsmokers, For the smokers those percentages were Among the Nigerians who reported smoke-free workplaces Additional analysis, which was performed for the smokers, indicated that among those who had a smoke-free work environment about half also lived in smoke-free homes The percentage of smoke-free homes was indicated much less frequently by smokers who declared SHS exposure in their workplace Among the nonsmokers, smoke-free home was declared by The highest proportion of the people who lived in smoke-free homes was observed in the South West region The people who lived in urban areas were more likely to indicate smoke-free homes compared to those from rural areas The current smokers and smokeless tobacco users were less likely to live in smoke-free homes compared to those who did not indicate any of these habits Table 3 presents the results of the unadjusted and adjusted logistic regression analyses of the predictors of a smoke-free home.
The study indicated that working in a smoke-free workplace was associated with a significantly higher likelihood of living in a smoke-free home after adjusting for a variety of confounders. In addition, the people living in urban areas as well as the nonsmokers and nonsmokeless tobacco users indicated significantly more frequently that they lived in smoke-free homes than those from rural areas, current smokers, and smokeless tobacco users.
A smokefree workplace policy: Reduces smoking prevalence by 3. Youth living in towns with laws making restaurants smokefree were less likely to progress to established smoking than youth who lived in towns with weak smoking restrictions odds ratio: 0. Second, we assess the potential public health consequences using a broad-based perspective. Finally, we consider public health, legal, and ethical principles and their implications in evaluating smoker-free workplaces as a public health intervention strategy.
There are currently no published evaluations of workplace policies barring employment to smokers. However, there is substantial evidence that policies which ban smoking in the workplace reduce cigarette consumption, increase attempts to quit, as well as decrease overall tobacco use prevalence. While it is currently unknown what effect smoker-free workplace policies would have on smokers, in Figure 1 we explore possible consequences using a causal loop diagram.
Positive signs note an increasing relationship, while negative signs signal a decreasing relationship. Thus, in a positive relationship if X increases then so does Y. In a negative relationship if X increases then Y decreases. Thus, an increase in X corresponds with an increase in Y. Thick arrows represent stated goals, thin arrows unintended consequences.
In building our model we recognize that employers and their employees operate within dynamic economic, social, political, and other relationships. Our model is not meant to be exhaustive, but rather illustrative based on the related public health evidence base. The ultimate goal is to begin to recognize potential immediate, delayed and distal impacts of workplace policies barring employment to smokers within all levels of the socio-ecological framework.
Implementation of a workplace policy barring employment to smokers leads to two potential outcomes for employed smokers.
First, some will quit smoking and maintain their current employment. Besides the obvious health benefits of tobacco cessation, these employees will also receive continued health insurance coverage if provided by their employer. Moreover, it is likely that their potential to relapse would be reduced due to the consequences of resuming smoking. Further, they will continue to benefit from being exposed to other workplace health promotion programs that are offered. For non-smoking employees at the worksite, tobacco cessation by fellow employees would lower exposure to environmental tobacco smoke if the worksite did not already have a smoke-free workplace policy in place.
The productivity of former smokers may increase, 37 though the evidence is limited regarding the productivity effects of workplace smoking bans. For instance, in St. Cloud, FL a ban on smoking employees was rescinded by the city council after employers found it difficult to find qualified employees.
As just noted, the second outcome for smokers working with employers who initiate a policy banning smoking is that they will either be terminated or resign.
Some of these smokers may try to quit and be unsuccessful. Nicotine is addictive, recognized as being on par with cocaine or heroin. For example, an employer could offer nicotine replacement therapy to their current smoking employees to help improve the chances of quitting. For those smokers who are unable to or refuse to cease tobacco use, some will re-enter the job market and find new employment. The consequences of even brief unemployment are more fully discussed below. Those smokers that do find new employment alter the remaining risk pool for other employers, 44 leading to rising health care costs for those workplaces.
In other words, the employment market will represent an increased proportion of smokers who are more costly to insure than non-smokers. There is the potential that in response to the corresponding rise in health care costs, other employers may also begin initiating policies barring employment to smokers. Smokers who are terminated or resign and are unable to find new employment represent the population at greatest risk for adverse health outcomes. If a smoker is unable to find new employment, however, this may also incentivize them to either attempt or re-attempt quitting smoking.
Part of the likelihood of smokers being unemployed for longer time periods is the availability of employers who will still hire smokers. If these policies continue to proliferate, this can become a very real possibility. It is easier to imagine this scenario having a real effect in rural areas where there may be only one or a few major employers.
Unemployment can lead to personal, family, and economic stressors that adversely impact health outcomes. In a series of landmark reports, the Institute of Medicine illustrated the potential consequences of lack of insurance on multiple domains of society. The uninsured have a more difficult time finding and utilizing health care services, and the care provided is often non-reimbursed.
Further, a growing uninsured population can create financial stresses that affect the ability of health care providers to provide services to the community. Finally, the uninsured represent lost opportunities of those individuals to more fully participate in society.
In broader social terms, smokers may feel stigmatized as well. Modified labeling theory posits that when social forces about behavior are communicated individuals may experience social devaluation and discrimination.
Work by Marmot and others has shown that people with the least feeling of control over their lives have the poorest health outcomes. A recent study on smoker stigma also shows that stigma effects may differentially impact smokers — those with greater education and whites perceived greater stigma than those with lower education and racial minorities.
Effects of labeling on individuals with mental illness and infectious and chronic diseases has been shown to impact health outcomes. Related to stigmatization, these policies may also have a broader social effect in continuing the denormalizaiton of tobacco use. Public health policies such as local ordinances against smoking at public parks and other measures represent a societal shift in how smoking is viewed.
Tobacco use is one of the leading causes of preventable illness and cause of death in many countries. Frequent tobacco use can lead to chronic lung diseases such as emphysema, bronchitis, pneumonia, cancers, and other heart ailments.
Below are some of the important stats on tobacco use :. Tobacco use may potentially increase health risks as it can affect different parts of the body, and may eventually lead to death. Unfortunately for smokers, nicotine is highly addictive, which makes it difficult for tobacco users to just stop right away. Nicotine causes the surge of adrenaline when it is absorbed into the bloodstream. This is the reason why individuals continuously smoke, because they feel a different kind of satisfaction when nicotine works into their system.
Addiction to tobacco may exhibit the following situations:. Complies with local by-laws and legislation. Employees who do not smoke take fewer sick days, go on disability less often, and are less likely to retire early because of poor health.A marked shift in tobacco-related workplace health promotion intervention involves the adoption of policies barring employment to smokers. We discuss the potential public health consequences of these policies on those affected — smokers, their families, the surrounding community, and society at large. We find a lack of published evidence evaluating the effectiveness and consequences of these policies. By developing a model of policy effects, we outline possible unintended consequences. With such large gaps in the evidence base and the potential for deleterious rree, we argue for pklicies discussion about the use of smoker-free employment policies as a public health intervention and for increased xmoke of employers by the public health community in worksite health promotion. The proliferation of clean indoor air laws has been described as occurring in four waves: 1 split large pdf files online free of the public from secondhand smoke in public places, such as elevators, movie theatres, retail stores, and public buildings; 2 smoke-free workplaces, focusing on office buildings while a secondary benefit of smoke free workplace policies is service workplaces, such as restaurants and bars; a secondary benefit of smoke free workplace policies is smoke-free restaurants; and 4 smoke-free bars benfit casinos. InWeyco stopped hiring smokers. The company also made a secondary benefit of smoke free workplace policies is off premises and outside work hours a firable offense. Smoker-free hiring policies are not unique to the United States. While smoker-free employment woorkplace are adopted by employers, the tobacco control movement has played some role in promoting these policies. In this section, three economic incentive policies are examined: 1 higher excise taxes on cigarettes, 2 preferential hiring and promotion of nonsmokers, and 3 insurance premium differentials for smokers and nonsmokers. There are a number of reasons given for implementing smoker-free workplace policies. Some employers cite value-based reasons: aligning the workforce with organizational philosophy. Opponents to the frew of a secondary benefit of smoke free workplace policies is workplace policies have focused mainly on issues of discrimination or privacy infringement. However, admin panel template free download html5 and css3 responsive remaining states have at-will employment, meaning that refusal to hire smokers sorkplace legal in these states. The promotion of smoker-free workplace policies has sparked a debate in the a secondary benefit of smoke free workplace policies is policie community, captured in a point-counterpoint debate in Tobacco Control. Despite the emergence of this issue into international tobacco control discussion sparked by the publication of these commentaries, we are not aware of much further published consideration of the issue. Moreover, we are not aware of any published attempts to define and outline the potential consequences of smoker-free hiring policies in an effort to analyze their likely effects and allow a more informed seconary about the issue. In this article, we hope to advance that debate by developing and presenting a model to consider the consequences — both a secondary benefit of smoke free workplace policies is and negative — of smoker-free workplace policies. Our goal is to call attention to, and engage public health professionals in a discourse on the possible effects and consequences of these new policies. A secondary benefit of smoke-free workplace policies is a. lower health insurance premiums.b. support for smokers quitting the habit. c. increased productivity.d. In this article, we will look into the effect of tobacco smoking at work, and how a smoke-free workplace policy can help company owners and. The primary stimulus for the smoke-free workplace has always been employee but an important secondary benefit is the consistently reported significant effect of population wide health benefits, then “smoker-free” workplace policies merit. A smokefree workplace policy: Reduces smoking prevalence by % among employees who smoke; Reduces daily smoking by cigarettes (per smoker). First, some will quit smoking and maintain their current employment. Besides the obvious health benefits of tobacco cessation, these employees will also receive. Implementation of totally smoke-free workplace policies was associated with a reduction in absolute prevalence of % (95% confidence interval % to %). The evidence suggests that smoke-free workplace policies may change social smoke-free policies in Nigeria that result in substantial health benefits. secondary school (OR = ;) had a higher chance of living in smoke-free homes. Finally, one of the greatest benefits an employer receives is the human capital gained through the implementation of a smoke-free workplace. Many employees. compensation, disability benefits, and other settlements based upon their exposure to secondhand smoke in the workplace • With a tobacco-free policy,. Access employer resources to help adopt and implement workplace policies that support a healthy work environment. Your tax-deductible donation funds lung disease and lung cancer research, new treatments, lung health education, and more. In these exempt businesses, as well as in areas not covered by the ICAA such as outdoor dining areas , workers and the public continue to be exposed to secondhand smoke. Worker health and well-being is an important part of establishing a healthy and safe workforce. One Third Two Thirds Column 2. To adapt a policy that concerns the over-all health of employees should be seen as a positive effect. Looking for Reasons to quit smoking A plan to get ready to quit Tips to stay on track Advice on having another go at quitting Ex-smokers' stories Fact sheets. Tobacco use is one of the leading causes of preventable illness and cause of death in many countries. Employers can implement company specific smoke-free policies in the absence of, or in addition to legislation. All tobacco products are harmful and may cause cancer and other diseases. Legislation that requires non-hospitality workplaces, restaurants, and bars to be completely smoke-free has been adopted by 27 states and the District of Columbia. Sample smokefree policy Most enclosed workplaces within Victoria become smokefree on the 1st of March By implementing laws and policies to make our communities smokefree, we can:. There are no exemptions for electronic cigarette retail outlets, smoke shops, bars or other venues. Gender differences in smoking among U.