Health

Published by ash June 2003:

Why Workplaces Should Be Smokefree 

Reasons why

• There is now incontrovertible evidence that secondhand smoke is a killer – at least 1,000 people die from secondhand smoke exposure each year in the UK 1.
• Some three million people 2 are still exposed to secondhand smoke in the workplace yet have little protection in law. Policies that aim to protect employees from tobacco smoke will also improve conditions for consumers.
• Expert advice by the World Health Organisation states that ventilation is not effective in protecting people from secondhand smoke as there is no safe level of exposure below which there are no adverse effects.3
• Public opinion supports smokefree workplaces – 78 per cent of the population 4 now believe that all employees should be able to work in a smokefree environment.
• 80 per cent of the population don’t smoke 5. If smokers make an informed decision to smoke then that’s their decision – but it should not be allowed to impact on other people’s health.
• 70 per cent of smokers would like to quit 6 and most believe smoke-free environments would help them in their quit attempts.
• The UK is lagging a long way behind many other countries in protecting non smokers from secondhand smoke 7.

Health Arguments

• Tobacco smoke is a potent cocktail of over 4,000 chemicals, including more than 50 known to cause cancer such as benzene and arsenic 8.
• Secondhand smoke exposure (equivalent to just 1 percent of that of active smoking) carries a risk of coronary heart disease of almost half that of smoking 20 cigarettes a day 5.
• People with particular illnesses are vulnerable to secondhand smoke, and they represent a substantial proportion of the population. For example there are 5.1 million people with asthma and 3 million with other types of lung disease, 2.1 million people with angina and 1.3 million people who have had a heart attack 5.
• Secondhand smoke is a major trigger of asthma attacks and worsens respiratory conditions like bronchitis 5.
• Exposure to secondhand smoke during pregnancy is linked to low birthweight and prematurity 9.
• The health of workers improves immediately when smoking is banned in the workplace 10.

Economic Arguments

• Smokefree policies cost less to put in place and enforce than policies allowing smoking 11.
• Insurance, cleaning and maintenance costs are significantly reduced in smokefree workplaces 12.
• Smokefree policies reduce smoking by employees, and are a cost-effective way of helping people quit smoking 13.
• Less smoking means less absenteeism, lower worker turnover and fewer accidents 14 15 16.
• Worldwide smokefree policies have been shown to have a positive or neutral impact on trade in bars and restaurants. The only studies showing a negative economic impact had tobacco industry backing and most were subjective and of poor quality 17.

References

1. BMA Towards smoke-free workplaces, Board of Science and Education & Tobacco Control Resource Centre November 2002
2. Survey source: MORI March 1999 Sample size:1,029 respondents
3. WHO policies to reduce exposure to environmental tobacco smoke 29-30 May 2000
4. Survey source: MORI Fieldwork dates: 20th – 24th March, 2003 Sample size: 1972 respondents
5. BMA Towards smoke-free workplaces, Board of Science and Education & Tobacco Control Resource Centre November 2002
6. Smoking related Behaviour & Attitudes Series OS no.18 June 2002
7. See ASH website for up to date information at http://www.ash.org.uk/html/workplace/html/smokefreenews.html
8. WHO International Agency for Research on Cancer (1986) Monograph vol.38 Tobacco Smoke. WHO IARC:Lyons.
9. Windham GC, Hopkins B, Fenster L, & Swan SH (2000) Pre-natal active or passive tobacco smoke exposure and the risk of pre-term delivery or low birthweight. Epidemiology 11:427-33
10. Eisner M, Smith A, Blanc P Bartenders respiratory health after establishment of Smoke-free Bars and Taverns JAMA 1998; 280 1909-1914
11. Ducatman A,McLellan R. Epidemiological basis for an occupational and environmental policy on environmental tobacco smoke, Amer. Coll. of Occup. And Environmental Medicine, 2000
12. Parrott S. Godfrey C. Cost of employee smoking in the workplace in Scotland. Tob. Control 2000:9(2):187-192
13. Fichtenberg CM,Glantz SA Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188-191
14. McGhee S, Adab P, Hedley A, et al. Passive smoking at work: the short term cost. J.Epidemiol Community Health 2000; 54(9): 673-6
15. Ryan J,Zwerling C,Jones M Cigarette smoking at time of hire as a predictor of employment outcome J.Occup Environ Medicine 1996;38(9):928-33
16. Ryan J, Zwerling C, Orav E Occupational risks associated with cigarette smoking: a prospective study. Am J Public Health 1992; 82(1):29-32
17. Scollo M et al Review of the quality of studies on the economic effects of smoke-free policies on the hospitality industry. Tobacco Control 2002; 12: 13-20

Further information

Clear the Air Coalition Statement:
http://www.ash.org.uk/html/workplace/html/ctac.html
More Clear the Air Campaign factsheets:
www.ash.org.uk/html/ctac.php
For detailed informaion visit ASH smokefree environments page:
www.ash.org.uk/?smokefree

Department of Community Medicine, University of Hong Kong, 7 Sassoon Road, Pokfulam, Hong Kong

Correspondence to: Dr McGhee (smmcghee@hkucc.hku.hk)

Accepted for publication 4 May 2000

STUDY OBJECTIVE: To estimate the impact of passive smoking at work on use of health care services and absenteeism.
DESIGN: Cross sectional survey.
SETTING: A workforce in Hong Kong.
PARTICIPANTS: 5142 never-smoking police officers in a total sample of 9926.

MAIN RESULTS: A consistently strong association was found among men between length of time exposed to passive smoking at work and self reported consultations with a doctor, use of medicines and time off work. Results for women were similar but most were not statistically significant.

CONCLUSIONS: The exposure of healthy adults to passive smoking at work is related to utilisation of health care services and extra time off work. This results in costs to the health services, to employers and to those exposed.

The following study was carried out in China to discover whether passive smoking at work is a risk factor for coronary heart disease. Of course, the results also apply to any other country where smoking at work can risk the health of non-smoking workers.

ttp://www.bmj.com/cgi/content/full/308/6925/380

The conclusion was that passive smoking at work is a risk factor for coronary heart disease. Urgent public health measures are needed to reduce smoking and to protect non-smokers from passive smoking in China.