Decreasing Tobacco Use Among Workers: Smoke-Free Policies Reduce Health Costs

Smoke-free policies include private-sector rules and public-sector regulations that prohibit smoking in indoor workplaces and designated public areas. Private-sector smoke-free policies may establish a complete ban on tobacco use on worksite property or restrict smoking to designated outdoor locations. Community smoke-free ordinances establish smoke-free standards for all or for designated indoor workplaces and public areas.

Interventions that work

A worksite may adopt a smoke-free policy alone or in combination with additional interventions to support tobacco-using employees who might seek assistance in quitting. These additional interventions include the following:

  • Tobacco-cessation groups
  • Educational materials or activities
  • Telephone-based cessation support
  • Counseling and assistance from healthcare providers
  • Access to effective pharmacologic therapies

Results from systematic reviews

Thirty-five studies in a recent review of companies introducing smoking-cessation efforts produced the following results:

  • Prevalence of tobacco use: median decrease of 3.4 percentage points
  • Tobacco use cessation: median increase in tobacco quit rates of 6.4 percentage points
  • Attempts to quit: median increase of 4.1 percentage points
  • Number of cigarettes smoked per day: median reduction of 2.2 cigarettes smoked per day

Economic effectiveness of smoking-reduction efforts

A review of the economic effectiveness of these interventions was conducted. Studies demonstrated a range of outcomes:

  • An assessment of a smoke-free workplace policy found a cost of $526 per quality of life adjusted year (QALY) compared to a cost of $4,613 per QALY for a free nicotine replacement therapy program
  • There is a collective net benefit from smoke-free policies ranging from $48 billion to $89 billion per year in the United States
  • A smoke-free workplace policy could prevent about 1,500 heart attacks and 350 strokes in one year with approximately $55 million in direct medical cost savings
  • An employer could potentially save $10,246 per year for every smoker who quits due to a smoke-free workplace policy.

These results were based on a systematic review of all available studies, conducted by a team of specialists in systematic review methods, and in research, practice and policy related to worksite health promotion and prevention of tobacco use.


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