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TOBACCO

FREE WORKPLACE

GUIDE POWERED BY The Albermarle Foundation Commitment to Prevention

TABLE OF CONTENTS 1

Introduction

Risks from Tobacco Use

Smoking in Louisiana

Benefits of a Tobacco-Free Workplace

Calculate the Cost of Smoking

Improving Workplace Health

10 Steps to a Tobacco-Free Workplace

1. Convene a Tobacco-Free Committee

2. Assess the Current Situation

3. Create a Timeline

4. Develop a Tobacco-Free Workplace Policy

5. Develop a Communication Plan

6. Pick a Meaningful Implementation Date

14-15

7. Create a Supportive Environment

8. Launch the Policy

9. Enforce the Policy

10. Monitor and Maintain the Tobacco-Free Workplace

19-20

Addressing Frequently Asked Questions

Resources

Sample Tobacco-Free Workplace Policy

Sample Announcement Letter

24-25

Benefits of Quitting Smoking

26-27

Lung Cancer Infographic

28-29

Head & Neck Cancer Infographic

Steps to Quitting

Cancers Caused by Tobacco Use

32-33

Sample Signage

Sample Tobacco Cessation Flier/Ad

INTRODUCTION

This Tobacco-Free Workplace Guide is a toolkit designed to assist

employers in providing a healthier environment for their employees by addressing workplace related tobacco issues and creating a tobacco free

policy. The toolkit explains the benefits of a tobacco-free workplace and outlines what you can do as an employer to assist your employees in

quitting tobacco while protecting non-smokers from secondhand smoke. According to the Center for Disease Control (CDC), tobacco use is responsible for approximately 480,000 deaths annually, nearly one in five deaths, and contributes to a number of smoking-related diseases including, but not limited to: cardiovascular and cerebrovascular disease, emphysema, bronchitis and multiple types of cancers. Secondhand smoke contributes to lung cancer and heart disease in non-smokers as well as

pediatric illnesses such as asthma, sudden death syndrome (SIDS) and ear-infections.1 Smoking is the leading preventable cause of death in the United States. According to the CDC, smoking-attributable economic costs in the United States are more than $300 billion each year, including nearly $170 billion for direct medical care of adults, and more than $156 billion in lost productivity due to premature death and exposure to second hand smoke. 2 By offering comprehensive tobacco cessation services, an employer can reduce employee smoking rates and environmental tobacco smoke exposure, decrease health care costs and employee absenteeism and increase productivity.3

RISKS FROM TOBACCO USE SMOKING CAN DAMAGE MANY PARTS OF THE BODY

SMOKING IN LOUISIANA

$1.89 BILLION

$803 MILLION

$1,182 PER HOUSEHOLD

$2.49

Annual HEALTH CARE COSTS in Louisiana directly caused by smoking

MEDICAID COSTS caused by smoking in Louisiana

Residentsâ€™ STATE & FEDERAL TAX BURDEN from smoking-caused government expenditures

BILLION

Smoking-caused PRODUCTIVITY LOSSES in Louisiana

21.9%

ADULTS IN LOUISIANA WHO SMOKE

32.6%

Proportion of CANCER DEATHS in Louisiana attributable to SMOKING

BENEFITS OF A TOBACCO FREE WORKPLACE Tobacco dependency is the number one preventable health problem in the United States. Employers are positioned to affect change by establishing tobacco-free policies, ensuring tobacco cessation benefit coverage and implementing work-place based tobacco cessation resources for their employees.

By making simple changes to your work environment, you can improve the health of your employees and ultimately, save your business money.

COST TO EMPLOYERS: In addition to an enormous health toll, there is a significant economic burden associated with tobacco use. Tobacco is also the single greatest cause of excessive health care spending and productivity losses for employers. According to a study by Ohio State University5 , a smoker costs a private employer in the U.S. an extra $5,816 per year compared to a nonsmoker. This dollar amount includes increased health care expenses, more frequent breaks, increased absenteeism and lost productivity for a smoker. Based on this study, you can use the following chart to help you determine the cost of smoking to your business.

CALCULATE THE COST OF SMOKING STEP 1:

ESTIMATE THE NUMBER OF SMOKERS AT YOUR WORKPLACE

X # OF EMPLOYEES

STEP 2:

21.9%

(LOUISIANA SMOKING RATE)

$3,760

# OF SMOKERS

= TOTAL LOST PRODUCTIVITY

CALCULATE THE COST OF ADDITIONAL MEDICAL CARE

$2,056

# OF SMOKERS

STEP 4:

# OF SMOKERS

CALCULATE THE COST OF LOST PRODUCTIVITY

STEP 3:

= TOTAL ADDED MEDICAL COSTS

CALCULATE THE ESTIMATED COST OF SMOKING TO YOUR BUSINESS

$2,056

TOTAL LOST

TOTAL ADDED

PRODUCTIVITY

MEDICAL COSTS

= TOTAL ANNUAL LOSS

IMPROVING WORKPLACE HEALTH By integrating educational information about tobacco use and exposure to secondhand smoke with other health and safety issues that are relevant to workers, management can gain support and acceptance of a new policy resulting in health and economic benefits for both workers and employees. 6 Tobacco-free policies benefit both smokers and non-smokers by

protecting all workers from unhealthy exposure to secondhand smoke and providing a supportive environment that helps smokers cut back or quit smoking all together.

FOR THE EMPLOYEES 7 • A tobacco-free environment helps create a SAFER, HEALTHIER WORKPLACE . • Workers who are bothered by smoke will NOT BE EXPOSED to it at work. • INSPIRES TOBACCO USERS TO QUIT. • Tobacco users appreciate a CLEAR COMPANY POLICY about tobacco use at work. • Managers are relieved when there is a CLEARLY DEFINED PROCESS for dealing with tobacco in the workplace.

FOR THE EMPLOYER • A tobacco-free environment helps create a SAFER, HEALTHIER WORKPLACE . • Direct health care COSTS TO THE COMPANY MAY BE REDUCED. • INCREASES EMPLOYEE MORALE by conveying that the business cares about the health and well-being of their employees and clients. • Employees may be LESS LIKELY TO MISS WORK due to tobacco-related illnesses. • MAINTENANCE COSTS GO DOWN when tobacco, smoke, matches and cigarette butts are taken out of work facilities. • LOWERS THE RISK OF FIRES, potentially reducing insurance costs. • Provides opportunity to LOWER RATES on health, life and disability insurance coverage as fewer employees use tobacco.

10 STEPS TO A TOBACCO-FREE WORKPLACE

CONVENE A TOBACCO-FREE COMMITTEE

A Tobacco-Free Committee will lead a company’s transition to a tobacco-free workplace by planning, developing, implementing and monitoring its tobacco policy. It is important to carefully select members of the committee that will represent all segments of your workforce to ensure you build an inclusive and influential team. Consider including representatives from the following departments and allow them to choose a committee chair:

• Administration

• Wellness Committee

• Human Resources

• Marketing/Communications

• Occupational Health and Safety

• Legal

• Facilities/Custodial

• Security

• General Staff Members – Tobacco Users and Non-Tobacco Users

You may also consider forming sub-committees to address the various components such as policy development, implementation, cessation services and evaluation.

DID YOU KNOW? QUITTING SMOKING LOWERS YOUR RISK FOR SMOKING-RELATED DISEASES AND CAN ADD YEARS TO YOUR LIFE.

ASSESS THE CURRENT SITUATION

• Determine whether there is a current smoke-free or tobacco-free policy at your workplace. If so, review the current policy, employee compliance and enforcement strategies. • Conduct a survey to establish an estimated number of employees who use tobacco • Share the results with a positive message “75 percent of our employees are non-smokers” • Determine what tobacco cessation services are available to employees and the adequacy of current health insurance coverage for tobacco dependence treatment (medication and counseling) • Review state and local laws/regulations on tobacco use:

American Lung Association – State Legislated Actions on Tobacco Issues (SLATI) www.lungusa2.org

DID YOU KNOW? SMOKING IS THE LEADING PREVENTABLE CAUSE OF DEATH IN THE UNITED STATES.

CREATE A TIMELINE

MONTHS 1

FORM AN ADVISORY COMMITTEE

ASSESS THE CURRENT SITUATION

CREATE A TIMELINE

DEVELOP A COMPREHENSIVE POLICY

DEVELOP A COMMUNICATION PLAN

PICK A MEANINGFUL IMPLEMENTATION DATE AND ANNOUNCE THE POLICY

CREATE A SUPPORTIVE ENVIRONMENT

LAUNCH THE POLICY AND HOST A KICK-OFF EVENT

ENFORCE THE POLICY

X X

10 MONITOR AND MAINTAIN THE POLICY

DEVELOP A TOBACCO-FREE WORKPLACE POLICY

All tobacco products are addictive and cause cancers and other serious health issues.

It is important to make your policy comprehensive to provide the best health benefits for all employees. To achieve this, include all forms of tobacco in your policy, such as cigarettes, spit tobacco, cigars, pipes and consider including electronic cigarettes and vaporizers. A comprehensive policy is more clear, consistent, effective and easier to enforce.

A TOBACCO-FREE POLICY SHOULD INCLUDE: • Purpose of the policy • A link between the policy and the organization’s values and strategies • Effective date • Who the policy applies to (employees, contractors, clients, visitors etc.) • Types of tobacco products defined • Communication of policy • Clear statement of where tobacco products are prohibited (owned property, leased facilities, parking lots, construction areas) • Clear statement of where/when tobacco products are NOT permitted (if anywhere) • Information on cessation services • Enforcement methods • Consequences of noncompliance • Create a FAQ document to accompany the policy

DEVELOP A COMMUNICATION PLAN

A communication plan is crucial in gaining initial and long-term support for a new policy. Maintaining open communication will help to reduce potential misunderstanding of the policy. The plan will ensure that all employees understand the timeline for

implementation, what resources are available for cessation and how the policy will be enforced. Each member of the Tobacco-Free Committee can help to share information throughout their departments.

TWO LEVELS OF COMMUNICATION SHOULD BE CONSIDERED:

LEVEL 1: Communication with managers and supervisors to help them understand the tobacco-free policy and their responsibilities for implementing and enforcing the new policies. Meetings and trainings to review the policy, discuss available cessation and support resources, discuss enforcement and non-compliance and review FAQ document to address possible employee concerns.

LEVEL 2: Communication with employees to help them understand how the new policy will directly affect them. Strategies include employee meetings, lunch and learns, orientations, intranet postings, a countdown and paystub messages promoting the new tobacco-free policy should be used. Also consider education regarding the harmful effects of tobacco use and secondhand smoke and tobacco cessation options available to all employees.

PICK A MEANINGFUL IMPLEMENTATION DATE

Choose a date that is linked to a national quit date or an important date for the organization that can be celebrated each year:

• KICK BUTTS DAY – March 17th • WORLD NO TOBACCO DAY – May 31st • GREAT AMERICAN SMOKE OUT – 3rd Thursday in November • ORGANIZATION’S ANNIVERSARY

DID YOU KNOW? MORE THAN 10 TIMES AS MANY U.S. CITIZENS HAVE DIED PREMATURELY FROM CIGARETTE SMOKING THAN HAVE DIED IN ALL THE WARS FOUGHT BY THE UNITED STATES DURING ITS HISTORY.

CREATE A SUPPORTIVE ENVIRONMENT

• Arrange for removal of ashtrays, cigarette butt receptacles, smoking benches etc. • Develop tobacco-free signage to post around campus • Post tobacco cessation information in breakrooms • Include notification of tobacco-free workplace on the company website • Offer support to tobacco users

PROVIDE TOBACCO CESSATION AND SUPPORT SERVICES Workplaces that are going tobacco-free should provide tobacco cessation opportunities to staff. Nicotine dependence requires multiple attempts before successfully quitting. Statistics show on average it takes a person 6-12 attempts before they successfully quit tobacco. Only 4.7 percent of unaided quit attempts (cold turkey) are successful, but proven tobacco treatment will increase an individual’s chances of becoming tobacco-free. Studies show that combining counseling and FDA-approved tobacco cessation medications and products the most effective method to quitting. 8 These products can help reduce employees’ nicotine cravings and withdrawal symptoms.

TOBACCO CESSATION COUNSELING Programs like Mary Bird Perkins – Our Lady of the Lake Cancer Center’s Geaux Free Tobacco Cessation Program have helped hundreds of people kick the tobacco habit. And while quitting is a challenge, we can provide the resources proven to help people prepare to quit, identify triggers that create urges, learn new behaviors to remain tobacco-free and develop a support network. Tobacco Cessation conseling is provided by a certified tobacco treatment specialist who will help develop an individualized plan based on the person’s tobacco use and tobacco assessment to assist the user to quit once and for all. Geaux Free provides a combination of the individual’s tobacco use assessment, education and recommendation of tobacco cessation products and medications, and individual or group counseling. Contact the tobacco cessation specialist at cstipe@marybird.com or call 225-215-1274.

QUITLINES Quitlines are also tobacco cessation resources effective in reaching across large populations. No matter where you live, you can take advantage of phone counseling to help you give up tobacco. Every state in the U.S. has a telephone quit line. Quit With Us, Louisiana is a resource website for the Louisiana Tobacco Quitline (1-800-QUIT NOW) phone and web-based counseling. It is a 24 hours a day, Seven days a week service that is free for all Louisiana residents age 13 and older who are ready to quit within the next 30 days. For more information visit online at www.quitwithusla.org or call 1-800-QUIT NOW.

DID YOU KNOW? SMOKING CAUSES DIMINISHED OVERALL HEALTH, SUCH AS SELF-REPORTED POOR HEALTH, INCREASED ABSENTEEISM FROM WORK, AND INCREASED HEALTH CARE UTILIZATION AND COST.

LAUNCH THE POLICY

Prior to the policy implementation, be sure that signage is posted throughout

the organization. Local and state agencies such as Louisiana Public Health Institute (LPHI.org) and The Louisiana Department of Health (ldh.louisiana.gov) are great resources to provide templates for tobacco free signage.

THIS PROPERTY IS

WE ARE PROUD TO BE

TOBACCO

FREE

THANK YOU

[COMPANY NAME OR LOGO]

KICK-OFF CELEBRATION The day of the policy implementation, hold a kick-off event to celebrate the tobacco-

free policy and your organizationâ€™s commitment to employee wellness. Also consider inviting community partners and local media to cover the event.

ENFORCE THE POLICY

Prior to the policy effective date, ensure that all parties responsible for

enforcement and non-compliance, such as human resources, security and administration, are clear and comfortable with their roles. Once the policy is implemented, management representatives should conduct occasional walk throughs of the campus, specifically areas where smoking was permitted in the past.

A FEW THINGS TO REMEMBER: • A tobacco use violation should be enforced like any other policy violation. • Follow the same procedures for other company policies such as a verbal warning, then a written notice, then disciplinary action. • Be sure to document and respond to complaints of violations in a consistent and timely manner. • Violations by visitors are usually not intentional and can be resolved by a simple verbal reminder or pointing out the policy signage. • Be clear on how and to whom employees should report violations.

DID YOU KNOW? 10 YEARS AFTER YOU QUIT SMOKING, YOUR RISK FOR LUNG CANCER DROPS BY HALF.

10 MONITOR & MAINTAIN THE TOBACCO-FREE WORKPLACE

Once implementation is complete, be sure to carefully monitor the process to identify and

address any non-compliance, confusion or employee concerns. Schedule a policy review every three to six months.

• Document lessons learned • Monitor and respond to employee comments and concerns • Monitor enforcement on all shifts • Adjust enforcement if necessary • Check for new laws that may affect your policy • Maintain management support and involvement through regular updates • Brief survey requesting feedback to employers. • Celebrate successes!

ADDRESSING FREQUENTLY ASKED QUESTIONS

Why is our organization going tobacco-free? A tobacco-free workplace will improve the overall health of our workplace for both employees and visitors. Tobacco-free policies benefit both smokers and non-smokers by protecting all workers from unhealthy exposure to secondhand smoke and providing a supportive environment that helps smokers cut back or quit all together. What does “tobacco-free” mean? The use of tobacco products, in any form, will be prohibited on property. This includes, but is not limited to: cigarettes, cigarillos, cigars, snuff, e-cigarettes, pipes and smokeless tobacco. Will I lose my job if I can’t/won’t quit using tobacco? No. We will provide an encouraging environment by offering tobacco cessation classes, education and resources to assist in your efforts. If an employee does not want to or cannot quit using tobacco, he or she will not be fired. However, employees are required to comply with the new tobacco-free policy, while on property. If the employee repeatedly does not comply with the policy, they are subject to disciplinary action up to termination. Can I smoke in my car? No. Tobacco use is not permitted on company property. Will compliance with this policy now be a part of my performance review? Adherence to all company policies is taken into account during performance reviews. Are there support programs to help me quit using tobacco? We will encourage and assist co-workers who wish to quit using tobacco products with individual or group tobacco cessation classes and/or links to free resources. Does an employer have the right to implement and enforce a tobacco-free policy? Yes. Employers may set policies and restrictions that are necessary to ensure that workplaces are safe and healthy environments for all employees and visitors.

ADDRESSING FREQUENTLY ASKED QUESTIONS

How will this policy be enforced? We will work together to enforce this policy. All employees smoking or using tobacco on the property after the implementation date will be asked to stop, reminded of the new policy and informed of tools and resources available to them. Any employee who does not comply will be reported to their supervisor. Repeat offenders are subject to disciplinary action set forth in the policy. Who will enforce the policy for contract workers who are outside employees? We have notified our contracted vendors of the Tobacco Free Workplace policy and the effective date. All vendors and contracted employees are expected to comply with this policy. How will visitors learn of the policy? We will post signage around the property that clearly states this is a tobacco-free workplace.

DID YOU KNOW? SMOKING CAN CAUSE CANCER ALMOST ANYWHERE IN YOUR BODY.

RESOURCES

SAMPLE TOBACCO FREE WORKPLACE POLICY Applies To: All (name of organization) employees, students, volunteers, interns, contract personnel, visitors Purpose: 1. To express (name of organization) â€™s commitment to promoting health and wellness among employees as we recognize and affirm that tobacco use causes cancer and other chronic diseases and is a major health and fire hazard. In addition to being responsible for almost 90 percent of lung cancers, tobacco use is also associated with cancers of the mouth, larynx, esophagus, throat, liver, stomach, colon and rectum, pancreas, cervix, kidney and bladder as well as myeloid leukemia. (Source: National Cancer Institute) . 2. Smoking accounts for at least 30 percent of all cancer deaths and is a major cause of heart disease, cerebrovascular disease, chronic bronchitis and emphysema, and is associated with gastric ulcers. (Source: American Cancer Society) .

Policy: 1. The use of all tobacco products, including cigarettes, cigars, pipes and any other tobacco-related product including smokeless tobacco, is prohibited on all company property. 2. The use of e-cigarettes, electronic nicotine delivery systems devices and any other smoking products or device is prohibited. 3. Tobacco use by employees, students, volunteers, interns, contract personnel, patients and visitors is prohibited in all facilities owned, leased, shared or operated by (name of organization) , including the parking garage and surrounding campus grounds. Additionally, this policy includes employees representing (name of organization) outside the office on (name of organization) business. Any violation of this policy will result in disciplinary action up to and including termination. 4. Tobacco use is not permitted in (name of organization) owned or leased vehicles. 5. Employees who choose to use tobacco must do so on their own time, off the premises of (name of organization) and off the clock. Non-exempt employees must clock out prior to leaving

the building and must clock in upon return. Failure to do so will lead to disciplinary action. 6. Enforcement is the responsibility of all (name of organization) staff. When violations of the (name of organization) Tobacco-Free Policy occur, initial responsibility for handling the violation rest with the

immediate supervisor. 7. Employees may contact the human resources department regarding tobacco cessation programs to assist individuals meet the workplace requirement.

SAMPLE ANNOUNCEMENT LETTER

To all employees, (Name of organization) is committed to improving the health of our employees and providing a safe

environment for all of our clients and visitors by incorporating a tobacco-free workplace. Tobacco use remains the most preventable cause of illness in the United States. Offering a tobacco-free workplace protects all employees from unhealthy exposure to secondhand smoke and provides a supportive environment that helps tobacco users cut back or quit using tobacco products for good. The new tobacco-free policy will go into effect on (date) . After this date, tobacco use will not be permitted on the (name of the organization) campus. We recognize that giving up tobacco is difficult and we are ready to assist any employee who needs support with educational resources and individual and/or group tobacco cessation counseling. In the next few months, you will receive additional information on the new tobacco-free policies and the resources available to you. Thank you for your cooperation during this transition and for helping to maintain a heathier environment for all. If you have any questions, please contact (HR representative and title) at (phone/email) . Sincerely,

BENEFITS OF QUITTING SMOKING

It doesn’t matter how long you’ve been smoking, how old you are or how bad your health is – quitting smoking has major and immediate benefits for everybody

STOP SMOKING AND WITHIN...

blood pressure, pulse rate and body temperature all return to normal

MINS

HOURS

2-12

WEEKS

your blood carbon monoxide level

drops and your blood oxygen level increases to normal

your chance of having a heart attack decreases

your nerve endings start to regrow and your ability to taste and smell greatly improves

breathing becomes easier

and your energy levels increase

your circulation improves, walking gets easier

BENEFITS OF QUITTING SMOKING

1-9

MONTHS

YEAR

YEARS

PLUS

coughing, sinus congestion, fatigue

and shortness of breath all decrease

your added risk of getting coronary heart disease is half that of a current smoker

your risk of getting cancer of the mouth, throat or esophagus is cut in half. Also, your risk of a stroke starts to become the same as that of someone who has never smoked.

your risk of lung cancer is about half that of a smoker, and your risk decreases for cancer of the bladder, cervix, kidney and pancreas. Your risk of having ulcers is also reduced.

you have the same risk of dying as a person who has never smoked. The same is true for your risk of getting coronary heart disease.

If youâ€™re pregnant and stop smoking early in

pregnancy, your risk of having a baby born too

small drops to normal. Your baby is also less likely to have other problems caused by smoking.

Talk to your healthcare professional about making a plan to quit smoking. Quitting smoking can be difficult, but millions of former smokers have done it successfully, and you can, too!

MARYBIRDLAKE.ORG/LUNG

STEPS TO QUITTING

CANCERS CAUSED BY TOBACCO USE

THIS PROPERTY IS

TOBACCO

FREE THANK YOU [COMPANY NAME OR LOGO]

WE ARE PROUD TO BE

TOBACCO

FREE THANK YOU [COMPANY NAME OR LOGO]

MARYBIRDLAKE.ORG/GEAUXFREE

“Centers for Disease Control and Prevention: Workplace Health Promotion” https://www.cdc.gov/wokplacehealthpromotion/health-strategies/tobacco-use/index.html

“Centers for Disease Control and Prevention: Smoking and Tobacco Use Fact Sheet” https://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/index.htm

3 “Centers for Disease Control and Prevention: Tobacco Cessation Reimbursement Brochure” https://www.cdc.gov/tobacco/quit_smoking/cessation/pdfs/reimbursement_brochure.pdf 4

www.tobaccofreekids.org

Berman, Crane, Seiber, and Munur, 2013, Estimating the cost of a smoking employee, Tobacco Control.

Reducing Social Disparities in Tobacco Use: A social-Contextual Model for Reducing Tobacco Use Among Blue Collar Workers, Glorian Sorensen, Elizabeth Barbeau, Mary Kay Hunt, and Karen Emmons American Journal of Public Health, 2004, 94, 2, 230-239.

American Cancer Society Tobacco-Free Workplace Toolkit, 2009.

U.S. Department of Health and Human Services. Treating Tobacco Use and Dependence, 2008.

American Lung Association: Benefits of Quitting www.lung.org/stop-smoking/i-want-to-quit/benefits-of-quitting.html

BRINGING CANCER PREVENTION TO THE WORKPLACE

MARYBIRDLAKE.ORG