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Decreasing Tobacco Use Among Workers: Smoke-Free Policies to Reduce Tobacco Use

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.

Summary of Task Force Recommendations & Findings

The Community Preventive Services Task Force recommends smoke-free policies based on sufficient evidence of effectiveness in reducing tobacco use among workers.

Smoke-free policies were found to be effective when:
  • Implemented by communities in the form of ordinances and regulations that prohibit smoking in indoor and enclosed work settings and public areas
  • Adopted by companies and organizations with multiple worksites
  • Implemented by individual worksites

The findings of this review complement the previous Task Force recommendations for smoking bans and restrictions based on strong evidence of effectiveness of these policies in reducing exposures to secondhand tobacco smoke.

Task Force Finding & Rationale Statement

About the Interventions

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

Results from the Systematic Reviews

Thirty-five studies qualified for the review.

  • Prevalence of tobacco use: median decrease of 3.4 percentage points (interquartile interval: –6.3 to –1.4 percentage points; 22 study arms)
  • Tobacco use cessation: median increase in tobacco quit rates of 6.4 percentage points (interquartile interval: 2.0 to 9.7 percentage points; 18 study arms)
  • Attempts to quit: median increase of 4.1 percentage points (interquartile interval: –0.7 to +6.8 percentage points; 6 studies)
  • Number of cigarettes smoked per day: median reduction of 2.2 cigarettes smoked per day (interquartile interval: –1.7 to –3.3 cigarettes/day; 18 studies)
  • Studies included in this review:
    • Evaluated responses from workers in a wide range of both public- and private-sector indoor worksites
    • Evaluated specific workplaces such as healthcare settings, telecommunications companies, and government worksites
    • Were conducted in the United States, Canada, Germany, Australia, and Finland

Economic Effectiveness

A review of economic effectiveness of this intervention was conducted. Studies included in this review 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 $4613 per QALY for a free nicotine replacement therapy program (one study).
  • There is a collective net benefit from smoke-free policies ranging from $48 billion to $89 billion per year in the United States (one study from 1994).
  • A smoke-free workplace policy could prevent about 1500 heart attacks and 350 strokes in one year with approximately $55 million in direct medical cost savings (one study).
  • An employer could potentially save $10,246 per year for every smoker who quits due to a smoke-free workplace policy (one study).

These results were based on a systematic review of all available studies, conducted on behalf of the Task Force 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.

Supporting Materials

Publications

Hopkins DP, Razi S, Leeks KD, et al. vices. Smoke-free policies to reduce Tobacco use: a systematic review. Adobe PDF File [PDF - 2.78KB] Am J Prev Med 2010;38(2S):275-289.

Task Force on Community Preventive Services. Recommendations for worksite-based interventions to improve workers' health. Adobe PDF File [PDF - 67KB] Am J Prev Med 2010;38(2S):232-236.

More Community Guide publications about Tobacco Use



Disclaimer

The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC.

Sample Citation

The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Decreasing tobacco use among workers: smoke-free policies to reduce tobacco use. www.thecommunityguide.org/tobacco/worksite/smokefreepolicies.html. Last updated: MM/DD/YYYY.

Review completed: June 2005