Perspectives in Disease Prevention and Health Promotion Workplace Smoking Survey -- New York City

During the period May 16-23, 1986, employees of the New York City Department of Health (NYCDOH) participated in a survey regarding smoking practices and attitudes toward a workplace smoking policy. The survey was conducted to obtain baseline information for evaluating the impact of a smoking policy initiated by the mayor and scheduled to be implemented July 1, 1986. It was also intended to familiarize employees with the policy.

Questionnaires were completed by employees who volunteered to attend one of several NYCDOH meetings concerning the mayor's proposed legislation and pending executive order about smoking restrictions. Of the estimated 900 employees in the department's primary office building, 608 attended the meetings, and 496 completed the survey. Thus, 55% of the total employees and 82% of those attending the meetings completed the questionnaire. Of the respondents, 137 (28%) currently smoked cigarettes, eight (2%) smoked pipes or cigars, 333 (67%) were nonsmokers, and 18 (4%) did not answer this question. The female to male ratio of respondents was 2.5:1. Thirty-one percent of the males and 28% of the females were current smokers. Eighteen percent of the smokers smoked a pack or more of cigarettes per day. Sixteen percent of the cigarette smokers reported that they did not smoke at work. Fifty-nine percent of nonsmokers reported at least occasional exposure to tobacco smoke from others in the workplace; 56% of nonsmokers reported at least occasional exposure to tobacco smoke from the visiting public.

Regarding employee attitudes toward smoking in the workplace, 63% of all respondents (26% of smokers and 79% of nonsmokers) reported being annoyed when other employees smoked nearby. Of nonsmokers, 38% reported that, when exposed to tobacco smoke, they would like to ask smokers to stop but are hesitant to do so. Thirty-three percent of nonsmokers reported that they were able to work without noticing smoke. Twenty-nine percent reported that they try to move away when other employees smoke. Overall, 82% of the respondents (including 69% of smokers) indicated that smoking in the workplace should be either limited (65%) or banned (17%). Most respondents indicated that restricting smoking in the NYCDOH would have no adverse effect on relations among their co-workers (87%), on their job performance (94%), or on their office morale (90%). Of current smokers, 46% indicated they would quit or reduce their smoking if workplace smoking were restricted. Reported by KJ Denard, MS, MK Bradstock, MD, MPH, P Clarke, MPH, Div of Health Promotion, SC Joseph, MD, MPH, New York City Dept of Health; Div of Environmental Hazards and Health Effects, Center for Environmental Health, Div of Health Education, Center for Health Promotion and Education, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: The control of smoking and tobacco smoke exposure in the workplace has become an important public health issue in the United States in recent years. No studies have yet quantified the nonsmoking worker's risk of lung cancer from chronic exposure to tobacco smoke in the workplace. However, numerous studies have documented that nonsmoking wives of smoking men have a risk of lung cancer that is between 14% and 34% higher than that of wives of nonsmoking men (1). In addition, it has been shown that employees exposed to sidestream tobacco smoke in the work environment are at greater risk of developing small airways dysfunction than are nonexposed employees (2). Small airways disease, which is the first pathological change seen in beginning smokers (3), may increase the risk of developing disabling chronic airways obstruction (4).

As a consequence of data such as these concerning the effects of sidestream tobacco smoke exposure, an increasing number of employers have instituted policies to control smoking in the workplace. While some policies and control measures have been adopted voluntarily, others have been required by legislative actions. There are already laws in 17 states and ordinances in at least 100 localities regulating workplace smoking (Office on Smoking and Health, unpublished data). In one recent national survey, 36% of 662 responding employers reported having established workplace smoking policies; an additional 2% planned to enact policies by the end of 1986, and 21% reported that policies were under consideration (5).

Despite the voluntary nature of the NYCDOH survey, the results are consistent with previously reported findings concerning employee knowledge, attitudes, and smoking practices in the workplace (6-10). Since this represents 55% of total NYCDOH employees, however, these results should be interpreted with caution. Smoking prevalence among respondents in this survey (28%) is similar to the estimates of national smoking prevalence (30%) (11). It is also similar to the prevalence reported for white collar workers (32% of females, 33% of males) (12) and for those in a surveyed private workplace (33%) (6).

In most surveys, the majority of respondents have approved of some limitation of smoking in the workplace (6-10). A nationwide survey commissioned by the American Lung Association (13) asked 1,540 randomly selected individuals whether companies should have a policy on smoking at work. Eighty-seven percent of all respondents--including 80% of smokers--indicated that smoking in the workplace should be limited. Surveys of employees at individual workplaces have provided similar support for smoking restrictions. For example, 74% of employees at a large health maintenance organization approved of a smoking prohibition policy 4 months after implementation of the policy (7). In another survey, 71% of all employees indicated that smoking in the immediate work area should be restricted (80% of nonsmokers and 51% of smokers) (6).

Policies limiting smoking in the workplace not only protect nonsmokers from the health effects of passive smoking but also may encourage smokers to quit or reduce smoking. In one survey, 51% of the employees who smoked indicated that workplace smoking regulations might prompt them to reduce smoking or try to quit smoking completely (6). In the NYCDOH survey, the majority of participating employees were in favor of restricting smoking in the workplace.

References

1. National Research Council. Passive smoking. Washington, DC: National Academy Press, 1986.

2. White JR, Froeb HF. Small-airways dysfunction in nonsmokers chronically exposed to tobacco smoke. N Engl J Med 1980;302:720-3.

3. Niewoehner DE, Kleinerman J, Rice DB. Pathologic changes in the peripheral airways of young cigarette smokers. N Engl J Med 1974;291:755-8.

4. Ingram RH. Chronic bronchitis, emphysema and airways obstruction. In: Petersdorf RG, Adams RD, Braunwald E, Isselbacher KJ, Martin JB, Wilson JD, eds. Harrison's principles of internal medicine. 10th ed. New York: McGraw-Hill Book Company, 1983:1546.

5. Bureau of National Affairs, Inc. Where there's smoke: problems and policies concerning smoking in the workplace. Washington, DC: Bureau of National Affairs, 1986.

6. Pacific Telephone and Telegraph Company. Employee smoking study (project no. 82-63). San Francisco: Pacific Telephone Company, January 1983.

7. Rosenstock IM, Stergachis A, Heaney C. Evaluation of smoking prohibition policy in a health maintenance organization. Am J Public Health 1986;76:1014-5.

8. Martin MJ, Silverman MF. The San Francisco experience with regulation of smoking in the workplace: the first twelve months. Am J Public Health 1986;76:585-6.

9. Sorensen G, Pechacek T, Pallonen U. Occupational and worksite norms and attitudes about smoking cessation. Am J Public Health 1986;76:544-9.

10. Anonymous. Other people's tobacco smoke . Lancet 1986;1:752.

11. Thornberry OT, Wilson RW, Golden PM. Health promotion data for the 1990 objectives. Estimates from the National Health Interview Survey of Health Promotion and Disease Prevention, United States, 1985. In: National Center for Health Statistics. Advance data from vital and health statistics. Hyattsville, Maryland: National Center for Health Statistics, 1986; DHHS publication no. (PHS) 86-1250, no. 126.

12. Office on Smoking and Health. The health consequences of smoking--cancer and chronic lung disease in the workplace: a report of the Surgeon General. Rockville, Maryland: Public Health Service, 1985. DHHS publication no. (PHS) 85-50207.

13. American Lung Association. Gallup survey (Press release). New York: American Lung Association, December 5, 1985.

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