Tobacco Use

Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions for tobacco use cessation include the public health evidence-base for each intervention, details on designing interventions for tobacco-use cessation, and links to examples and resources.

Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measure for these programs are listed under evaluation of tobacco-use cessation programs.

Tobacco use contributes to an extensive list of serious diseases, including cardiovascular and cerebrovascular diseases, multiple cancers, emphysema, and bronchitis; and second-hand smoke contributes to pediatric illness. In addition to this enormous health burden, smoking also imposes a major economic burden on society, costing the United States more than $300 billion each year, including

• Nearly $170 billion for direct medical care of adults
• More than $156 billion from lost productivity (e.g., increased use of sick leave, etc.) due to premature death.^1,2

Tobacco products exist in several forms including cigars, pipes, cigarettes, hookahs (or water pipes), small cigars, bidis (small, thin hand-rolled cigarettes imported to the United States primarily from India and other Southeast Asian countries), chewing tobacco, and snuff. The interventions described in this section focus on smoked forms of tobacco, though several of them could apply to other forms.

The two major purposes of tobacco cessation programs in the workplace are encouraging tobacco users to quit, and reducing employees exposure to second-hand smoke. Tobacco-free workplace policies and decreasing the numbers of employees who model tobacco-use behavior will also reduce tobacco use initiation among employees and, in addition, may influence tobacco-use behavior in employees families. Nicotine addiction is often severe and may require mulitple quit attempts (8 to 11) before the tobacco user can quit permanently. Health benefits should be structured to provide support for multiple quit attempts.