January 22, 2023

The Triple Threat of Tobacco Use on Employer, Clinical, and Medication Complexity

They say that old habits are hard to kick, and tobacco consumption is perhaps the oldest use of addictive substances on record in North America.

Recent archaeological evidence uncovered in Utah indicates tobacco use as early as 12,000 to 12,500 years ago, although how exactly it was used at that time is unknown. Regarding tobacco pipe smoking specifically, current science dates the practice as far back as 1685-1530 BC, based on evidence of nicotine identified in a smoking tube found at the Flint River archaeological site in northern Alabama.

More than 3,000 years later, the impacts of smoking tobacco products continue to have significant consequences for the health of the global population at large. Despite significant and continued declines in cigarette smoking prevalence since its widespread popularity in the 1960s, the practice still causes nearly half a million deaths each year and remains the #1 preventable cause of death in this country.

These mortality rates are just one piece of the story, as for every death, there is exponential morbidity, healthcare utilization, and costs associated with tobacco smoking.

Recognized as a patient risk factor within workers’ compensation healthcare, tobacco use, including cigarette smoking, has specific impacts on employee and injured worker patient populations.

Tobacco Use in Worker Populations: 5 Fast Facts

  1. Smoking has detrimental impacts to worker productivity, including both absenteeism and presenteeism factors
  2. Rates of tobacco use are higher among blue collar occupations, with the highest prevalence of cigarette smoking in construction, mining and manufacturing
  3. The average additional cost associated with employing a smoker are estimated at more than $7,000 annually
  4. Tobacco use increases fracture risk, slows healing, and is linked to increased risk for post-surgical complications that increase morbidity, mortality, and healthcare interventions
  5. Tobacco smoke can negatively interact with a number of medications prescribed in workers’ compensation

Employee Complexity Drivers Lower Productivity and Higher Costs

Even before the complicating factor of a workplace injury, employers face added complexity and costs in their employee populations due to tobacco smoking. In 2013, the added costs associated with employing a smoker vs nonsmoker were estimated at $5,186. Adjusting for annual average inflation, that puts today’s estimate at more than $7,000.

These excess costs are driven by factors that include added healthcare services and costs, as well as costs due to lost work time and reduced productivity, which can come in the form of absenteeism as well as presenteeism – the concept of an employee being present at work, but not fully functioning or having their performance hindered by illness or a medical condition.

Rather than ill-intentioned, this is often the employee’s best effort to still show up and perform their job duties in the face of anything from allergies to depression. However even with the best of intentions, it has been posited that the hidden costs of presenteeism can result in greater financial loss to the employer than direct healthcare costs.

Smoke breaks are another contributor to lost time and productivity. In a public health report published in 2020, former U.S. Surgeon General Dr. Jerome Adams underscored findings from the 2013 study, stating that smoking breaks are “the largest single cost from a smoking employee and result in 8 to 30 minutes per day per employee in lost work time.”

Continue reading the article in full at RxInformer.

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