I choose to be smoke-free. A Workplace Guide for Employers



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I choose to be smoke-free. A Workplace Guide for Employers Committed to a Healthier Mississippi.

Table of Contents Preface...1 Questions & Answers...2-3!...4-10 Sample Workplace Survey...11 The scientific evidence is now indisputable: Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and non-smoking adults. Former U.S. Surgeon General Richard H. Carmona Resources...12 Copyright 2006, Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Co. All rights reserved.

Resources For Information Call: American Cancer Society 1-800-ACS-2345 (www.cancer.org) National Cancer Institute 1-800-4-CANCER (www.cancer.gov) American Heart Association 1-800-AHA-USA1 (www.americanheart.org) American Lung Association 1-800-LUNG-USA (www.lungusa.org) Office on Smoking and Health, Centers for Disease Control and Prevention 1-800-CDC-INFO (www.cdc.gov/tobacco) Agency for Healthcare Research and Quality 1-800-358-9295 (www.ahrq.gov/consumer) 12 Preface This guide will help you be successful in implementing a smoke-free workplace. Tobacco use includes cigarettes, cigars, pipes, as well as smokeless tobacco. The terms smoke-free and tobacco-free will be used interchangeably throughout this guide. This guide will answer the smoke-free questions: why, what, where, when, who, and how. It will also provide you with step-by-step directions to develop your own smoke-free program. These steps helped Blue Cross & Blue Shield of Mississippi become a smoke-free company, and they can help you too. Blue Cross & Blue Shield of Mississippi became smoke-free on January 1, 2006. The decision to become smoke-free has been a great success for our company. Championed by our President and CEO, employees who used tobacco were encouraged to quit smoking and adopt a healthier lifestyle. Now, we are bringing to you our research and hands-on experience. Along the way you may notice suggestions for different steps in the process. If you need to adjust these to fit your specific needs, please do so! We do know that with your help we can make a healthier Mississippi, one person at a time. Let s get started! Blue Cross & Blue Shield of Mississippi became smoke-free on January 1, 2006. The decision to become smoke-free has been a great success for our company. Championed by our President and CEO, employees who used tobacco were encouraged to quit smoking and adopt a healthier lifestyle. 1

Why, what, where, when, who, and how? Sample Workplace Survey Please take a few minutes to complete this survey. This survey is completely confidential, you don t have to give your name. 1. Do you currently use tobacco? 2. Have you ever attempted to quit? Questions & Answers Q: Why is being smoke-free important for companies as well as individuals? A: Most people today know that smoking is a hazard to your health, but did you know that secondhand smoke or environmental tobacco smoke (ETS) is dangerous for those who do not smoke? Research done by the U.S. Centers for Disease Control and Prevention shows us that more than 3,000 non-smokers die from lung cancer each year and 400,000 new heart disease cases develop due to secondhand smoke. The good news is that you, as an employer, can provide a healthier work environment for your employees! Yes Yes 3. Does anyone in your family smoke or use tobacco? Yes 4. Please indicate your current tobacco use status: Currently smoke cigarettes Currently use smokeless tobacco Used to smoke Never smoked Currently smoke pipe/cigar Never used smokeless tobacco 5. What is your opinion of a smoking policy for the workplace? Company grounds should be entirely smoke-free/tobacco-free. The building should be entirely smoke-free/tobacco-free. Smoking should be allowed in rooms with separate ventilation, dedicated only to smoking. Please specify the location Q: What does a smoke-free company look like? A: A smoke-free company is one where everyone, including employees, vendors and visitors, is free from tobacco and cigarette smoke on company time. It is also a company that cares about the health of its employees and provides support for those who want to stop using tobacco. Q: Where do we start? A: You already have. Reading this guide is a stepping stone to becoming smokefree. There are nine steps in this guide to help you succeed. Take one step at a time, one day at a time, and soon you will see results one employee at a time. Q: When can the company expect to see results? A: Results can be seen immediately. Before your actual smoke-free implementation date, you, as the company, will let the employees know that you have decided to be a smoke-free workplace. That will start discussions among employees. You may even have people reducing their tobacco intake in preparation for being smoke-free, or quitting altogether with your help. We will discuss this further in this guide. 6. Should your company offer smoking cessation programs? 7. Should your company offer incentives to encourage employees to quit? 8. Do you think secondhand smoke is harmful to your health? Frequently bothered Occasionally bothered Yes Seldom bothered Never bothered 10. If you are bothered by secondhand smoke at work, in what way are you bothered? (check all that apply) Eye, nose and throat irritation Concern for your long-term health Headaches Pregnancy related concerns Interference with work performance Other, please specify For current tobacco users only: 11. Do you avoid certain activities because of restrictions on tobacco use? Yes, all the time Sometimes Rarely Never 12. Does smoking interfere with your daily work activities (productivity, ability to work)? Quite a bit A little bit Never 13. Would you participate in a company-sponsored program to help you stop smoking? Yes No Maybe 14. If smoking were not allowed in the workplace, how would this affect the amount you currently smoke? It would not affect it I would smoke less 2 Yes 9. Please indicate the extent to which you are bothered by secondhand smoke at work. Sometimes be healthy. be smoke-free. Yes Thank you for your assistance! I would smoke more at home I would try to quit. 11

STEP 8: Analyze Your Success At the end of the first year, review the progress your company is making. The information gathered can be used to revise your tobacco cessation program if necessary. Review the success of becoming smoke-free: the number of people who have quit or reduced their intake of tobacco, and those who were not successful. Ask the participants which area of the tobacco cessation program is helping them reach their goal. Review how well being smoke-free is supported by employees. Analyze all short- and long-term returns such as impacts on your absenteeism and other productivity markers, healthcare costs, etc. STEP 9: Celebrate Your Success! be healthy. be smoke-free. - Blue Cross & Blue Shield of Mississippi CONGRATULATIONS! You are now smoke-free. You have taken measures to have healthier employees and you should be proud of your success. You also have joined us in the commitment to promote a smoke-free and healthier state. It s time to celebrate! Hold a year-end celebration for your employees. Invite all those who have quit smoking to be your guests of honor. It is a hard task to quit smoking and these people have made an extraordinary effort. Make sure that the smokers who have not completely stopped are recognized for their efforts and let them know that they still have support. Provide recognition for the quitters of the group. Have your Champion recognize them individually and reward them with a certificate, award or a gift. 10 Why, what, where, when, who, and how? Q: Who will benefit from a smoke-free workplace? A: Being smoke-free benefits the company as well as employees who do and do not smoke. It gives smokers a chance to quit for good in a supportive environment, it gives non-smokers fresh air and a healthy working environment, and it gives you, as the employer, healthier employees and a healthy corporate image. Some of the benefits gained by becoming smoke-free are: Employer Benefits Healthy workplace Less absenteeism Increased productivity Shows employees that the company cares Provides a healthier image of the company to the community Long-term impact on healthcare costs Employee Benefits Healthy workplace Decreased sickness healthier Better quality of life Encourages smokers to quit Employees are not exposed to smoke at the workplace Smokers appreciate a clear company policy about smoking at work Q: How will I know that becoming smoke-free was successful? A: When you become a smoke-free company, you will automatically be successful because you will have made a change that provides a healthier workplace. Other markers for success will be a reduction in your employees who smoke and your employees who cut down on their tobacco intake. Your company will be recognized as a business that cares about its employees health, their families, and the environment. Reducing cigarette consumption by approximately 12% will save Mississippi $14.5 million on heart attack and stroke costs. Dr. Robert McMillen, Research Fellow & Associate Research Professor, Social Science Research Center, Mississippi State University 3

The steps below are your nine steps to success. They will be individually discussed and addressed in this guide. You have already completed step number one Make the Decision to be Smoke-Free, so you are on your way! Make Your Decision to be Smoke-Free Understand Your Current Environment Develop Your Tobacco Cessation Program Announce Your Policy and Cessation Program Enroll Your Employees Support Your Employees Go Smoke-Free Analyze Your Success Celebrate Your Success! STEP 1: Make Your Decision To Be Smoke-Free The primary benefit of a tobacco-free environment is the protection of ALL employees from the health risks of Environmental Tobacco Smoke (ETS). -U.S. Centers for Disease Control and Prevention This is one of the smartest decisions you can make for your company. The U.S. Environmental Protection Agency states that each year ETS kills an estimated 3,000 adult non-smokers from lung cancer and that thousands more die from ETSrelated heart disease. Simply separating smokers and non-smokers does not eliminate exposure to ETS and its subsequent health effects. Did you know that if a person is in a smoke-filled area for just 30 minutes, it is the equivalent of that person smoking one cigarette? The effects of tobacco really come to life when they are explained in those terms. The good news is that you are ready to put a stop to ETS at your workplace and provide your company with a healthy and tobacco-free environment. After your decision and before you can actually become smoke-free, you must first develop an action plan. Here are a few suggestions: STEP 6: Support Your Employees Quitting tobacco is a hard thing to do! Supporting your employees is a key element in the success of your program. Display signs of support and encouragement throughout the company. Call your program enrollees at least quarterly. This would be a good time to make sure they are on the right track. If they are not, help them get back on it. Congratulate any success they have had. For the non-smoking employees, extend congratulations to them for providing support to their co-workers! As your company moves closer to the smoke-free date, ensure all employees remain aware of the upcoming date in communications from your program Champion. STEP 7: Go Smoke-Free Now that your employees are on the road to a healthier lifestyle and they are making progress, it s time for your company to be SMOKE-FREE! It might be a good idea to send out a letter 2-3 days ahead of time to your managers or to all employees to remind them of your smoke-free date. On the date you have chosen, implement your policy. Remove all smoking effects in and around your company (such as ashtrays, smoking benches) to discourage anyone from smoking on your campus. Place smoke-free signs around your company and at each entrance to let everyone know you are now a smoke- and tobacco-free company. Find your Champion. You want to find a high profile person or leader in the company to act as a Champion. This person can be someone who has already conquered smoking or is willing to quit and be a role model for the cessation program. 4 9

Promote the policy and tobacco cessation program using your existing communication channels, such as newsletter articles, signs in employee break rooms, on bulletin boards, or any other high traffic areas, including parking areas and entryways. Ensure that all new hires know of your intentions and have them sign a copy of the tobacco-free policy. STEP 5: Enroll Your Employees The enrollment process should be simple and easy to implement, but it should also be comprehensive. Keep good records to help you track your employees in the tobacco cessation program and help you measure results. A few tips for enrollment are: Ensure the employees understand who they contact about enrollment, and that it makes sense to the employees. For example, establishing a department like Human Resources, Health & Wellness, or the Benefits department, as the key contact for the program will simplify enrollment. Offer a tobacco cessation program enrollment packet to those who want to join your program, and to other employees who smoke (using information gathered from the survey you conducted). Collect employee contact information using an enrollment form so the program administrator can contact enrollees throught the program. Clearly explain whether tobacco cessation materials will be distributed or if there will be employee assistance for the program. The employee should sign or initial this area to confirm their understanding of the process. There should be a place for the employee to sign acknowledging that he/she is doing this on a voluntary basis. After an employee enrolls in the tobacco cessation program, send them a personalized letter. Let them know you are proud of their efforts and that your company will support them during the transition to be smoke-free. 8 Form a Cessation Committee made up of representatives throughout the company such as human resources, benefits, administrative or facilities management. Also think about some members of management and general employee population (smokers and non-smokers). This team will help develop your plan and present new and creative ideas on how to implement it. Now that you have your smoke- and tobacco-free Champion and Cessation Committee, it is time to define the extent of your policy. The following is a list of the guidelines Blue Cross & Blue Shield of Mississippi established for this step: Tobacco use is prohibited on company property or adjoining property No-tobacco-use rule applies to both vendors and visitors to the company Applies to all in-state and out-of-state offices or company events No tobacco use on business travel No tobacco use in company vehicles All employees are required to sign a tobacco-free policy statement Decide on the date your company will become smoke-free and write it down. Allow at least three (3) to six (6) months prior notice before implementing this policy to allow all employees to be aware of the policy change and prepare for it. Some employees may even take it upon themselves to quit smoking before the smoke-free date. STEP 2: Understand Your Current Environment It has been determined by the U.S. Department of Health and Human Services that 75% of employed persons do not smoke. It was also noted that 79% of current employed smokers agree that exposure to ETS is harmful to healthy adults. Both of these statistics add reasons to be smoke-free. You must understand your current environment to be successful. A count of your current employees who smoke and what they may require from you must be determined. A checklist of the smoking areas in and around your company should also be collected so you will know where to address the no-tobacco rules. Here is a list of items that you may want to include: Evaluate smoking areas and be ready to discard ashtrays and other smoking effects. Determine what you will do with those areas once the new policy is in place. 5

Determine the number of smokers and/or tobacco users and their readiness to quit smoking. Implementing a survey of current employees may be useful. (See page 11.) Keep a record of these surveys so you can use them to evaluate the success of the program. Measure current productivity levels of tobacco users and non-users (i.e. unscheduled absences, consistent tardies, excessive sick time, etc.). You may even want to hold a small focus group with 10-12 current smokers and ask what they would look for in a workplace tobacco cessation program. STEP 3: Develop Your Tobacco Cessation Program After your decision and before you become smoke-free, develop an action plan for your tobacco cessation program. Here are a few suggestions: Determine the extent to which your company will help employees with their quit efforts; will you fund nicotine replacement therapy such as nicotine patches, gum, or lozenges? If so, how long will you provide that support? Now that you have determined the support model, establish the resources you may have around the program. For example, if you have an Employee Assistance Program (EAP), try to incorporate this behavior counseling service into your program. Determine the enrollment process for employees who want to join your cessation program, such as how they will sign up, and who will be the point-of-contact (this will also help you track enrollees and evaluate the on-going program later). Document your tobacco cessation program components and be ready to communicate this program to your employees when you announce the upcoming smoke-free policy (more on this in step 4). It may be a great idea to initiate an employee tobacco cessation support group at work. They could meet on their lunch hours once a week or bimonthly. Another factor which may be helpful is to offer employee incentives to quit smoking throughout the program. Possible incentives could be: 6 See the Resources page for additional support in developing your tobacco cessation program. If your group is covered by Blue Cross & Blue Shield of Mississippi and is committed to implementing a smoke-free workplace policy, you may be eligible to participate in our be smoke-free tobacco cessation program. Company T-shirt at the start of the program for those who enroll. Provide a designated area for workers who would like to form a support group. Monetary reward of your choice for program completion (i.e. $50 gift card to a store or a restaurant). Free day off after the completion of their program and after an additional six months of being smoke-free. An award or certificate at the completion of the program. STEP 4: Announce Your Policy and Cessation Program Now that you have developed your plan, it is time to announce to your employees that your company will become smoke-free and you will have a new tobacco cessation program. Communicate your reasons for the policy a healthier working environment for everyone. Do this with great fanfare; this should be an exciting time for all! Introduce the company Champion and have the announcement come from him or her. Before announcing the policy to all employees, announce it to the managerial staff. Make sure they understand the policy and the cessation program. Consider including sensitivity training to help the management team understand nicotine addiction and withdrawal, and how to help employees deal with difficulty. It is important to offer all employees support and encouragement. Announce to all employees the new policy and program and the date that you will be going smoke-free. Encourage your non-smoking employees to be a support system for fellow employees who do smoke. Ensure that your new tobacco-free policy is included alongside your regular employment policies. The policy should include the company s stance on tobacco use and the reasoning behind your decision to be tobacco-free. Include in your policy the employee(s) responsible for communicating the expectations of being tobacco-free to vendors, visitors, customers, contractors, etc., and that this policy will apply to them when they are on company property. 7

Determine the number of smokers and/or tobacco users and their readiness to quit smoking. Implementing a survey of current employees may be useful. (See page 11.) Keep a record of these surveys so you can use them to evaluate the success of the program. Measure current productivity levels of tobacco users and non-users (i.e. unscheduled absences, consistent tardies, excessive sick time, etc.). You may even want to hold a small focus group with 10-12 current smokers and ask what they would look for in a workplace tobacco cessation program. STEP 3: Develop Your Tobacco Cessation Program After your decision and before you become smoke-free, develop an action plan for your tobacco cessation program. Here are a few suggestions: Determine the extent to which your company will help employees with their quit efforts; will you fund nicotine replacement therapy such as nicotine patches, gum, or lozenges? If so, how long will you provide that support? Now that you have determined the support model, establish the resources you may have around the program. For example, if you have an Employee Assistance Program (EAP), try to incorporate this behavior counseling service into your program. Determine the enrollment process for employees who want to join your cessation program, such as how they will sign up, and who will be the point-of-contact (this will also help you track enrollees and evaluate the on-going program later). Document your tobacco cessation program components and be ready to communicate this program to your employees when you announce the upcoming smoke-free policy (more on this in step 4). It may be a great idea to initiate an employee tobacco cessation support group at work. They could meet on their lunch hours once a week or bimonthly. Another factor which may be helpful is to offer employee incentives to quit smoking throughout the program. Possible incentives could be: 6 See the Resources page for additional support in developing your tobacco cessation program. If your group is covered by Blue Cross & Blue Shield of Mississippi and is committed to implementing a smoke-free workplace policy, you may be eligible to participate in our be smoke-free tobacco cessation program. Company T-shirt at the start of the program for those who enroll. Provide a designated area for workers who would like to form a support group. Monetary reward of your choice for program completion (i.e. $50 gift card to a store or a restaurant). Free day off after the completion of their program and after an additional six months of being smoke-free. An award or certificate at the completion of the program. STEP 4: Announce Your Policy and Cessation Program Now that you have developed your plan, it is time to announce to your employees that your company will become smoke-free and you will have a new tobacco cessation program. Communicate your reasons for the policy a healthier working environment for everyone. Do this with great fanfare; this should be an exciting time for all! Introduce the company Champion and have the announcement come from him or her. Before announcing the policy to all employees, announce it to the managerial staff. Make sure they understand the policy and the cessation program. Consider including sensitivity training to help the management team understand nicotine addiction and withdrawal, and how to help employees deal with difficulty. It is important to offer all employees support and encouragement. Announce to all employees the new policy and program and the date that you will be going smoke-free. Encourage your non-smoking employees to be a support system for fellow employees who do smoke. Ensure that your new tobacco-free policy is included alongside your regular employment policies. The policy should include the company s stance on tobacco use and the reasoning behind your decision to be tobacco-free. Include in your policy the employee(s) responsible for communicating the expectations of being tobacco-free to vendors, visitors, customers, contractors, etc., and that this policy will apply to them when they are on company property. 7

Promote the policy and tobacco cessation program using your existing communication channels, such as newsletter articles, signs in employee break rooms, on bulletin boards, or any other high traffic areas, including parking areas and entryways. Ensure that all new hires know of your intentions and have them sign a copy of the tobacco-free policy. STEP 5: Enroll Your Employees The enrollment process should be simple and easy to implement, but it should also be comprehensive. Keep good records to help you track your employees in the tobacco cessation program and help you measure results. A few tips for enrollment are: Ensure the employees understand who they contact about enrollment, and that it makes sense to the employees. For example, establishing a department like Human Resources, Health & Wellness, or the Benefits department, as the key contact for the program will simplify enrollment. Offer a tobacco cessation program enrollment packet to those who want to join your program, and to other employees who smoke (using information gathered from the survey you conducted). Collect employee contact information using an enrollment form so the program administrator can contact enrollees throught the program. Clearly explain whether tobacco cessation materials will be distributed or if there will be employee assistance for the program. The employee should sign or initial this area to confirm their understanding of the process. There should be a place for the employee to sign acknowledging that he/she is doing this on a voluntary basis. After an employee enrolls in the tobacco cessation program, send them a personalized letter. Let them know you are proud of their efforts and that your company will support them during the transition to be smoke-free. 8 Form a Cessation Committee made up of representatives throughout the company such as human resources, benefits, administrative or facilities management. Also think about some members of management and general employee population (smokers and non-smokers). This team will help develop your plan and present new and creative ideas on how to implement it. Now that you have your smoke- and tobacco-free Champion and Cessation Committee, it is time to define the extent of your policy. The following is a list of the guidelines Blue Cross & Blue Shield of Mississippi established for this step: Tobacco use is prohibited on company property or adjoining property No-tobacco-use rule applies to both vendors and visitors to the company Applies to all in-state and out-of-state offices or company events No tobacco use on business travel No tobacco use in company vehicles All employees are required to sign a tobacco-free policy statement Decide on the date your company will become smoke-free and write it down. Allow at least three (3) to six (6) months prior notice before implementing this policy to allow all employees to be aware of the policy change and prepare for it. Some employees may even take it upon themselves to quit smoking before the smoke-free date. STEP 2: Understand Your Current Environment It has been determined by the U.S. Department of Health and Human Services that 75% of employed persons do not smoke. It was also noted that 79% of current employed smokers agree that exposure to ETS is harmful to healthy adults. Both of these statistics add reasons to be smoke-free. You must understand your current environment to be successful. A count of your current employees who smoke and what they may require from you must be determined. A checklist of the smoking areas in and around your company should also be collected so you will know where to address the no-tobacco rules. Here is a list of items that you may want to include: Evaluate smoking areas and be ready to discard ashtrays and other smoking effects. Determine what you will do with those areas once the new policy is in place. 5

The steps below are your nine steps to success. They will be individually discussed and addressed in this guide. You have already completed step number one Make the Decision to be Smoke-Free, so you are on your way! Make Your Decision to be Smoke-Free Understand Your Current Environment Develop Your Tobacco Cessation Program Announce Your Policy and Cessation Program Enroll Your Employees Support Your Employees Go Smoke-Free Analyze Your Success Celebrate Your Success! STEP 1: Make Your Decision To Be Smoke-Free The primary benefit of a tobacco-free environment is the protection of ALL employees from the health risks of Environmental Tobacco Smoke (ETS). -U.S. Centers for Disease Control and Prevention This is one of the smartest decisions you can make for your company. The U.S. Environmental Protection Agency states that each year ETS kills an estimated 3,000 adult non-smokers from lung cancer and that thousands more die from ETSrelated heart disease. Simply separating smokers and non-smokers does not eliminate exposure to ETS and its subsequent health effects. Did you know that if a person is in a smoke-filled area for just 30 minutes, it is the equivalent of that person smoking one cigarette? The effects of tobacco really come to life when they are explained in those terms. The good news is that you are ready to put a stop to ETS at your workplace and provide your company with a healthy and tobacco-free environment. After your decision and before you can actually become smoke-free, you must first develop an action plan. Here are a few suggestions: STEP 6: Support Your Employees Quitting tobacco is a hard thing to do! Supporting your employees is a key element in the success of your program. Display signs of support and encouragement throughout the company. Call your program enrollees at least quarterly. This would be a good time to make sure they are on the right track. If they are not, help them get back on it. Congratulate any success they have had. For the non-smoking employees, extend congratulations to them for providing support to their co-workers! As your company moves closer to the smoke-free date, ensure all employees remain aware of the upcoming date in communications from your program Champion. STEP 7: Go Smoke-Free Now that your employees are on the road to a healthier lifestyle and they are making progress, it s time for your company to be SMOKE-FREE! It might be a good idea to send out a letter 2-3 days ahead of time to your managers or to all employees to remind them of your smoke-free date. On the date you have chosen, implement your policy. Remove all smoking effects in and around your company (such as ashtrays, smoking benches) to discourage anyone from smoking on your campus. Place smoke-free signs around your company and at each entrance to let everyone know you are now a smoke- and tobacco-free company. Find your Champion. You want to find a high profile person or leader in the company to act as a Champion. This person can be someone who has already conquered smoking or is willing to quit and be a role model for the cessation program. 4 9

STEP 8: Analyze Your Success At the end of the first year, review the progress your company is making. The information gathered can be used to revise your tobacco cessation program if necessary. Review the success of becoming smoke-free: the number of people who have quit or reduced their intake of tobacco, and those who were not successful. Ask the participants which area of the tobacco cessation program is helping them reach their goal. Review how well being smoke-free is supported by employees. Analyze all short- and long-term returns such as impacts on your absenteeism and other productivity markers, healthcare costs, etc. STEP 9: Celebrate Your Success! be healthy. be smoke-free. - Blue Cross & Blue Shield of Mississippi CONGRATULATIONS! You are now smoke-free. You have taken measures to have healthier employees and you should be proud of your success. You also have joined us in the commitment to promote a smoke-free and healthier state. It s time to celebrate! Hold a year-end celebration for your employees. Invite all those who have quit smoking to be your guests of honor. It is a hard task to quit smoking and these people have made an extraordinary effort. Make sure that the smokers who have not completely stopped are recognized for their efforts and let them know that they still have support. Provide recognition for the quitters of the group. Have your Champion recognize them individually and reward them with a certificate, award or a gift. 10 Why, what, where, when, who, and how? Q: Who will benefit from a smoke-free workplace? A: Being smoke-free benefits the company as well as employees who do and do not smoke. It gives smokers a chance to quit for good in a supportive environment, it gives non-smokers fresh air and a healthy working environment, and it gives you, as the employer, healthier employees and a healthy corporate image. Some of the benefits gained by becoming smoke-free are: Employer Benefits Healthy workplace Less absenteeism Increased productivity Shows employees that the company cares Provides a healthier image of the company to the community Long-term impact on healthcare costs Employee Benefits Healthy workplace Decreased sickness healthier Better quality of life Encourages smokers to quit Employees are not exposed to smoke at the workplace Smokers appreciate a clear company policy about smoking at work Q: How will I know that becoming smoke-free was successful? A: When you become a smoke-free company, you will automatically be successful because you will have made a change that provides a healthier workplace. Other markers for success will be a reduction in your employees who smoke and your employees who cut down on their tobacco intake. Your company will be recognized as a business that cares about its employees health, their families, and the environment. Reducing cigarette consumption by approximately 12% will save Mississippi $14.5 million on heart attack and stroke costs. Dr. Robert McMillen, Research Fellow & Associate Research Professor, Social Science Research Center, Mississippi State University 3

Why, what, where, when, who, and how? Sample Workplace Survey Please take a few minutes to complete this survey. This survey is completely confidential, you don t have to give your name. 1. Do you currently use tobacco? 2. Have you ever attempted to quit? Questions & Answers Q: Why is being smoke-free important for companies as well as individuals? A: Most people today know that smoking is a hazard to your health, but did you know that secondhand smoke or environmental tobacco smoke (ETS) is dangerous for those who do not smoke? Research done by the U.S. Centers for Disease Control and Prevention shows us that more than 3,000 non-smokers die from lung cancer each year and 400,000 new heart disease cases develop due to secondhand smoke. The good news is that you, as an employer, can provide a healthier work environment for your employees! Yes Yes 3. Does anyone in your family smoke or use tobacco? Yes 4. Please indicate your current tobacco use status: Currently smoke cigarettes Currently use smokeless tobacco Used to smoke Never smoked Currently smoke pipe/cigar Never used smokeless tobacco 5. What is your opinion of a smoking policy for the workplace? Company grounds should be entirely smoke-free/tobacco-free. The building should be entirely smoke-free/tobacco-free. Smoking should be allowed in rooms with separate ventilation, dedicated only to smoking. Please specify the location Q: What does a smoke-free company look like? A: A smoke-free company is one where everyone, including employees, vendors and visitors, is free from tobacco and cigarette smoke on company time. It is also a company that cares about the health of its employees and provides support for those who want to stop using tobacco. Q: Where do we start? A: You already have. Reading this guide is a stepping stone to becoming smokefree. There are nine steps in this guide to help you succeed. Take one step at a time, one day at a time, and soon you will see results one employee at a time. Q: When can the company expect to see results? A: Results can be seen immediately. Before your actual smoke-free implementation date, you, as the company, will let the employees know that you have decided to be a smoke-free workplace. That will start discussions among employees. You may even have people reducing their tobacco intake in preparation for being smoke-free, or quitting altogether with your help. We will discuss this further in this guide. 6. Should your company offer smoking cessation programs? 7. Should your company offer incentives to encourage employees to quit? 8. Do you think secondhand smoke is harmful to your health? Frequently bothered Occasionally bothered Yes Seldom bothered Never bothered 10. If you are bothered by secondhand smoke at work, in what way are you bothered? (check all that apply) Eye, nose and throat irritation Concern for your long-term health Headaches Pregnancy related concerns Interference with work performance Other, please specify For current tobacco users only: 11. Do you avoid certain activities because of restrictions on tobacco use? Yes, all the time Sometimes Rarely Never 12. Does smoking interfere with your daily work activities (productivity, ability to work)? Quite a bit A little bit Never 13. Would you participate in a company-sponsored program to help you stop smoking? Yes No Maybe 14. If smoking were not allowed in the workplace, how would this affect the amount you currently smoke? It would not affect it I would smoke less 2 Yes 9. Please indicate the extent to which you are bothered by secondhand smoke at work. Sometimes be healthy. be smoke-free. Yes Thank you for your assistance! I would smoke more at home I would try to quit. 11

Resources For Information Call: American Cancer Society 1-800-ACS-2345 (www.cancer.org) National Cancer Institute 1-800-4-CANCER (www.cancer.gov) American Heart Association 1-800-AHA-USA1 (www.americanheart.org) American Lung Association 1-800-LUNG-USA (www.lungusa.org) Office on Smoking and Health, Centers for Disease Control and Prevention 1-800-CDC-INFO (www.cdc.gov/tobacco) Agency for Healthcare Research and Quality 1-800-358-9295 (www.ahrq.gov/consumer) 12 Preface This guide will help you be successful in implementing a smoke-free workplace. Tobacco use includes cigarettes, cigars, pipes, as well as smokeless tobacco. The terms smoke-free and tobacco-free will be used interchangeably throughout this guide. This guide will answer the smoke-free questions: why, what, where, when, who, and how. It will also provide you with step-by-step directions to develop your own smoke-free program. These steps helped Blue Cross & Blue Shield of Mississippi become a smoke-free company, and they can help you too. Blue Cross & Blue Shield of Mississippi became smoke-free on January 1, 2006. The decision to become smoke-free has been a great success for our company. Championed by our President and CEO, employees who used tobacco were encouraged to quit smoking and adopt a healthier lifestyle. Now, we are bringing to you our research and hands-on experience. Along the way you may notice suggestions for different steps in the process. If you need to adjust these to fit your specific needs, please do so! We do know that with your help we can make a healthier Mississippi, one person at a time. Let s get started! Blue Cross & Blue Shield of Mississippi became smoke-free on January 1, 2006. The decision to become smoke-free has been a great success for our company. Championed by our President and CEO, employees who used tobacco were encouraged to quit smoking and adopt a healthier lifestyle. 1

Table of Contents Preface...1 Questions & Answers...2-3!...4-10 Sample Workplace Survey...11 The scientific evidence is now indisputable: Secondhand smoke is not a mere annoyance. It is a serious health hazard that can lead to disease and premature death in children and non-smoking adults. Former U.S. Surgeon General Richard H. Carmona Resources...12 Copyright 2006, Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Co. All rights reserved.

Committed to a Healthier Mississippi. 3545 Lakeland Drive Flowood, Mississippi 39232 www.bcbsms.com Blue Cross & Blue Shield of Mississippi, A Mutual Insurance Company, is an independent licensee of the Blue Cross and Blue Shield Association. Registered Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans. BCBS 22519 Rev. 12/06