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The Estimated Annual Cost per Smoking Employee for an Employers

Posted Aug 12 2013 12:00am

There is a growing movement among hospitals and health related non-profit corporations not to hire smokers (see: Tobacco-Free Hiring Takes Hold; Both Smoking and Smokers ExcludedThe Financial Stakes Escalate for Employees Who Smoke ). These policies are partly based on the need for health organizations to "vote with their feet" regarding health issues and also on the anticipated cost savings because smokers take more days off and experience high medical bills. However, I did not have a good idea about the incremental costs of such employees until I came across a recent article (see: The Cost of a Smoker: $5,816 ). Below is an excerpt from it:

A smoker costs a private employer in the United States an extra $5,816 per year compared with a nonsmoker, according to an analysis of data collected from earlier studies on the costs of smoking. Researchers at The Ohio State University estimated that the largest cost, at $3,077 annually, came from taking smoking breaks. Smokers took, on average, about five breaks a day, compared with the three breaks typically sanctioned for most workers. The second largest cost, at $2,056, was related to excess health care expenses. Smokers typically have more health problems than nonsmokers, including heart and lung disease and various cancers.The remaining costs came from increased absenteeism — the researchers found that smokers miss about two-and-a-half extra workdays each year — and lost productivity at work, perhaps because of nicotine’s withdrawal effects. The findings appeared online in June in the journal Tobacco Control.“We certainly encourage businesses to provide smoking cessation programs. At least for large companies, it’s highly likely to save them money over time,” said Micah Berman, an assistant professor of public health and law at Ohio State and lead author of the analysis.“We as a country, as communities, need to be making more efforts to address smoking systematically, not just through cessation but prevention,” he added.

This cost of nearly $6,000 per employee is probably big enough to get the attention of any employer. It's interesting that the lead author of the study, Micah Berman, emphasizes the need now to emphasize prevention as opposed to cessation regarding employee smoking policies. Certainly the denial of an opportunity to work for respected employer ratchets up the cost of a smoking habit. One of the aspects of the hospital non-hiring policies that I find interesting is that some of them take a prospective employer's word that he or she is a non-smoker. Other runs a blood test, serum cotinine, to assess the current smoking status of the individual. Here's my note about cotinine from nearly seven years ago: Saliva and Urine Tests for Smoking . An interesting question is whether a prospective employee who tests positive for cotinine can claim that the positive test is due to passive smoke inhalation from others at home. Here's the answer to this question (see: Biomonitoring Summary: Cotinine ):

Once absorbed, nicotine has a half-life in blood plasma of several hours. Cotinine, the primary metabolite of nicotine, is currently regarded as the best biomarker of tobacco smoke exposure. Measuring cotinine is preferable to measuring nicotine because cotinine persists longer in the body with a plasma half-life of about 16 hours. However, non-Hispanic blacks metabolize cotinine more slowly than do non-Hispanic whites. Cotinine can be measured in serum, urine, saliva, and hair. Nonsmokers exposed to typical levels of SHS [secondhand tobacco smoke] have serum cotinine levels of less than 1 ng/mL, with heavy exposure to SHS producing levels in the 1–10 ng/mL range. Active smokers almost always have levels higher than 10 ng/mL and sometimes higher than 500 ng/mL.

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