Addition by subtraction Featured

7:00pm EDT January 31, 2007

Quitting smoking is easy,” begins a quote attributed to Mark Twain. “I’ve done it hundreds of times.” This sage quip cuts to the truth — resolving to stop smoking is effortless, but staying quit is extremely challenging.

This is a concern to corporate employers, because it’s been proven that healthy people take less time off due to sickness or injury and are generally more productive at work because they feel better. “It’s suggested that the business expense from smoking-related issues, such as extra sick time and health care expense, totals more than $1 billion,” says Michael Sayette, Ph.D., professor of psychology and psychiatry at University of Pittsburgh.

According to the American Cancer Society, companies that implement smoking-cessation programs may see their direct health care costs reduced. In addition, a well-planned and carefully implemented effort by the employer to address the effect of smoking on employees’ health and the health of their families shows that the company cares. And employees may be less likely to miss work due to smoking-related illnesses.

Smart Business discussed with Sayette why smoking cessation is a critical but difficult lifestyle change.

Why should employers be concerned about employees’ smoking habits?

The most obvious reason is that smoking can kill you. Smoking-related issues cause over 400,000 premature deaths per year. Experts suggest that one-third of all cancer results from smoking, including cancer of the esophagus, larynx and kidneys. Among lung cancer deaths, 80 percent to 90 percent happen in the smoking population. The No. 1 cause of death among smokers is heart disease, and smokers have twice the normal risk of suffering from this illness.

In addition to concern for employees’ longevity, business leaders should also be aware of smoking’s dramatic negative effect on health and productivity.

How can businesses help their employees quit smoking?

Stopping smoking takes internal resolve so most people who quit, quit on their own. Also, many people attempt to quit four or five or six times before they stop permanently. Having some failed attempts doesn’t mean they’re doomed.

Companies can help encourage smoking cessation by setting a tone for the issue. When businesses clearly set it as a serious concern and commit to helping employees quit, they can have an impact.

The treatment programs that address both the physical and behavioral sides of the addiction have the highest rate of smokers who permanently quit. On the chemical side, people attempting to quit can use nicotine replacement therapy, like a nicotine patch or gum. This therapy helps decrease the withdrawal and craving symptoms. Some other prescription medicines also can help smokers quit.

In addition to addressing the chemical concerns, effective programs look at the emotional needs of people quitting smoking. Behavioral counseling, either face-to-face or over the phone, can help individuals break smoking habits developed over years. When routine tasks from pouring a cup of coffee to getting in the car trigger a desire to smoke, people need to learn to break these associations to smoking and create new routines that do not involve smoking.

Investing in smoking cessation programs can yield a substantial return on investment by creating a happier, healthier work force.

Why is quitting smoking so difficult?

My research focuses on answering this question. Smoking is one of the most difficult addictions to overcome. Among people who smoke and drink, about 90 percent of them say it’s more challenging to quit smoking than drinking.

One of the reasons smoking cessation is so difficult is that the effects of nicotine happen so quickly. When someone smokes, nicotine enters the brain in seven seconds. With other addictive substances like alcohol or caffeine, dramatic effects don’t happen so rapidly.

Emotional states can also play a major role in relapsing back to smoking after attempting to quit. My research focuses on understanding how these states, such as cigarette craving, affect people’s resolve to stop smoking.

MICHAEL SAYETTE, Ph.D., is a professor of psychology and psychiatry at University of Pittsburgh. He has researched and published on addictions for two decades. The Chamber Choice program provides a wide variety of benefits for chamber of commerce employees, including smoking cessation programs. Find out more by phoning (800) 377-3539 or visiting