Tobacco Cessation Services Provided by Worksites
Some employers provide employees with access to tobacco cessation counseling or education classes in the
workplace. This model can be especially important for rural workers who may lack time or transportation options
to access these resources outside of the workplace.
Many employers include this cessation treatment as part of a
larger workplace wellness program. Workplace wellness programs are offered by employers to their employees to
promote positive health habits. Programs may provide incentives to attend no-cost health education seminars or
reimburse employees for fitness center memberships. Some employers may also support employees' attempts to quit
using tobacco by providing coverage for evidence-based tobacco treatments or reducing the out-of-pocket costs
for these services.
There are many advantages to providing employees with tobacco cessation services. The Centers for Disease
Control and Prevention (CDC) reports that employers break even when implementing a tobacco cessation program
within three years and begin saving money within five years. In addition, employees who quit smoking can reduce
costs associated with cardiovascular disease and other smoking-related conditions. Workers who use tobacco
products may also be less productive than those
who do not.
The CDC, the Agency for Healthcare Research and Quality (AHRQ), and the National Business Group on
Health prepared A Purchaser's Guide to Clinical
Preventive Services: Moving Science into Coverage. The Guide informs employers that are designing
health benefits about recommended clinical preventive services. For employers seeking to support
employees' tobacco cessation efforts, the guide recommends the following evidence-based guidelines:
Incentives and Competitions to Increase Smoking Cessation among Workers
In this model, worksites sponsor competitions for employees that promote smoking cessation, or
provide incentives for abstaining from tobacco use. A competition could involve a contest that
rewards a worker who abstains from tobacco for the greatest number of days abstinent. Incentives,
such as a monetary reward, may be provided. This model is
effective when combined with other evidence-based interventions, including cessation groups,
education, self-help materials, telephone support, smoke-free policies, and social support networks.
This model is effective in urban and suburban settings, but has not been rigorously evaluated in
Examples of Tobacco Cessation Programs Provided by Rural Worksites
The West Florida Area Health Education
Center—which serves rural
populations in Escambia, Okaloosa, Santa Rosa, and Walton Counties—offers to hold tobacco
cessation classes at local businesses. Employers can select either a one-time education session,
Tools to Quit, or a
comprehensive tobacco cessation program, Quit
Smoking Now. All classes are led by a Certified Tobacco Treatment Specialist and program
participants receive free Nicotine Replacement Therapy to support their efforts to quit.
Pacific Railroad (UPRR) has offered tobacco cessation benefits to its employees,
many of whom live in rural areas, since 1990. UPRR has provided a range of educational services that include
information about smoking behavior such as Know
Your Health Numbers trainings and peer support programs. In addition, the company offers
cessation services that include access to telephone, in-person, and internet counseling, as well as
coverage for tobacco cessation medication.
In 2005, three businesses in rural Wisconsin implemented a worksite wellness initiative called the
Wellness Initiative. At one worksite, six of 53 participating employees quit smoking
during the nine week program.
Considerations for Implementation
The Tobacco Control Legal Consortium fact sheet, Legal
Considerations in Implementing a Tobacco Cessation Program in the Workplace, suggests
that employers seeking to establish a tobacco cessation program should first consult with a legal professional
to discuss liabilities and legal implications. In particular, employers may need to familiarize themselves with
nondiscrimination regulations when designing tobacco cessation programs. This is particularly important
for employers seeking to implement policies that increase health insurance premiums (in other words, impose
penalties) for employees who smoke.
Program Clearinghouse Examples
Resources to Learn More
Your Way Worksite Toolkit: Strategies for Creating a Healthier Work Force and Bottom Line
This toolkit aims to provide employers with strategies to adopt tobacco-related insurance benefits in
order to help their employees quit tobacco use.
Organization(s): Tobacco Free Florida, Florida Department of Health
Employer Guide to Tobacco
This toolkit examines the healthcare costs related to smoking, shows advantages of having a
smoke-free workplace, provides information on the legal issues involved, and gives suggestions for
helping employees quit smoking.
Organization(s): WorkSHIFTS, Public Health Law Center
for the Development of Effective Agency Tobacco Cessation Programs
This guide provides recommendations to government agencies that are developing tobacco cessation
programs for employees.
Organization(s): Office of Personnel Management
the Affordable Care Act Affects Tobacco Use and Control
This fact sheet lists and explains the main sections of the Affordable Care Act (ACA) that relate to
insurance coverage for tobacco cessation programs.
Organization(s): Tobacco Control Legal Consortium
This Cochrane Review examines the impact of incentives and contingency management programs on
long-term quit rates.
Author(s): Cahill, K., Hartmann-Boyce, J., & Perera, R.
Citation: Cochrane Library
Quit and Win
Contests for Smoking Cessation
This Cochrane Review examines whether quit and win contests contribute to higher long-term quit rates
than baseline community quit rates.
Author(s): Cahill, K. & Perera, R.
Citation: Cochrane Library
Health Strategies: Tobacco-Use
The CDC provides information and compiled resources for employers seeking to implement tobacco
cessation programs and policies.
Organization(s): Centers for Disease Control and Prevention
Interventions for Smoking Cessation
This Cochrane Review examines the outcomes of controlled studies for workplace smoking cessation
Author(s): Cahill, K. & Lancaster, T.
Citation: Cochrane Library