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4 Important Questions on Employee Wellbeing and Tobacco Use

4 Important Questions on Employee Wellbeing and Tobacco Use

Recently, we joined 3 of our clients in a webinar on strategies for protecting employee wellbeing—including how to support those who struggle with tobacco addiction.

Several viewers had compelling questions that weren’t answered before the program’s close, so we wanted to address them here, since they’re important topics to discuss:

  1.  I’m an HR manager in a manufacturing facility with many smokers and vapers. What is the most successful and productive way to address cessation and quitting, without being patronizing?

Start with compassion. Nicotine dependence is an addiction, and it often takes multiple times for people to quit even when they’re desperate to be on the other side of it.

People seem patronizing when they imply that smokers and vapers aren’t struggling, or that they don’t have enough “willpower” needed to quit. When you provide meaningful resources, though, it shows that you understand it’s tough, and you want to help.

One way to do this is by putting a workplace tobacco-free policy into action. Another way is to offer an evidence-based cessation program that’s easy to access and provides a community that makes your employees feel they belong. Be sure to promote your program year-round and in a way that doesn’t shame tobacco users, but resonates instead. For example, make sure promotional materials include a diverse and inclusive range of tobacco users.

Normalize quitting and celebrate those successes. Rather than making your employees who smoke or vape feel like they need to hide their addiction from you, put these resources into action and they’ll feel supported.

  1. For those who have a tobacco-use surcharge, is that applied to the employee only or does it apply to the employee’s spouse/dependent who is covered on the employee’s benefits?

It’s advisable to apply the surcharge to everyone covered through your workplace medical plan, including a spouse and any dependents.

There is compelling evidence that having other tobacco users in the home makes it harder to quit and stay quit. On the flipside, having support from a spouse often leads to more success. A surcharge can be helpful for being one more nudge in the right direction. Secondhand smoke is a known health hazard and driver of lost productivity, too.

  1. Are there any concerns about disparate impacts on class, race, ethnicity, etc., with nicotine surcharges?

This is a valid concern because addressing tobacco use is a social justice issue. It’s important to understand the history of tobacco marketing in the U.S. and that racial and ethnic minorities have been targeted by the tobacco industry.

However, time and time again, incentives show they motivate tobacco users to try and quit. Nearly 1 out of every 5 employers uses tobacco surcharges, for a reason: They work.

For more details on what works with tobacco surcharges, see our blog “Tobacco Surcharge: What the Evidence Shows Will Help People Quit.”

  1. How do you handle the employees who lie about quitting? According to them, they don’t use tobacco so you don’t charge them the surcharge but other staff tell you they are still smoking.

First, let’s talk about what it means to quit. Many quit-tobacco programs measure being quit at 30 days, 3 months, 6 months, and so on. Be clear on how you’re defining it. If it’s 30 days and staff say they saw the employee smoking “a couple months ago,” that may be outside the timeframe for the surcharge.

Also, remember it’s an addiction and relapses happen. An employee could have been tobacco-free at 30 days but then relapsed and had a couple cigarettes before re-committing to the quit. Does that wipe out all the success of a smoke-free month?

On average, it takes 6 or more times to quit, especially during times of stress. With the pandemic and its many stressors, that can trigger relapse as a way to cope. That’s why it’s so important to offer a program that provides ongoing support and unlimited quit attempts.

Another way to approach this comes from an EX Program client. This client has employees sign a pledge to be tobacco-free throughout the year. Those who use tobacco can commit to be tobacco-free and complete a reasonable alternative standard (RAS) by a designated timeframe. Those who do not complete the RAS in the required time or who do not pledge to be tobacco-free, pay a surcharge.

This client communicates its code of ethics when completing enrollment each year, which says that the employee understands that intentionally providing false or misleading information is considered a breach of the company’s code of ethics.

Consequences for falsifying tobacco status include revocation of the discount, repayment of discounted premiums received, and could result in disciplinary action up to and including dismissal from the company. For more insights into this client’s tobacco-free policy and incentive structure, see our on-demand webinar “Kicking Butts: How to Help Employees Quit Tobacco with Incentives.”

If your question wasn’t covered here, we’re happy to offer answers and start a conversation about what you need in your workplace. Connect with us to learn more about the EX Program and to schedule a demo.

Missed our webinar, “4 Expert Perspectives on Protecting Employee Well-Being”? It’s available on-demand. Plus, you can earn certification credit for watching. Visit the Society for Human Resource Management site to learn more.


Megan Jacobs, MPH
Megan Jacobs, MPH

Managing Director of Product, Innovations

Megan Jacobs is responsible for the design, delivery, and evaluation of the EX Program. Most recently, Jacobs led the EX Program team responsible for the first evidence-based text messaging program to help e-cigarette users of all ages quit. She formed her expertise in mHealth interventions and public health campaigns with her work at the University of Michigan Health Service, DC Department of Health, and the National Vaccine Program Office. Her public health work over the past 15 years has applied technology to behavior change ranging from adolescent sexual health to vaccinations. Jacobs received her Master of Public Health from the Milken Institute School of Public Health at George Washington University and is also a graduate of the University of Michigan.

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