The risks and costs of smoking are no secret: Smoking is the single biggest cause of preventable premature death in the developed world. It is a significant factor in disability and death due to lung cancer, heart disease, emphysema, and chronic bronchitis. Non-smokers exposed to tobacco smoke face serious risks as well. Secondhand smoke contains higher concentrations of many cancer-producing chemicals than does inhaled smoke.

This all carries over and has an impact in the workplace. Absenteeism is higher among smokers than among non-smokers and, where smoking is allowed at work, productivity is lower and job-related accidents higher among smokers. General cleaning and maintenance costs are also higher where smoking is permitted.

Given all of this, it's surprising that greater attention isn't paid to smoking cessation in the workplace. Results of the 1992 National Workplace Survey show that less than half of all worksites in Canada offer any sort of smoking cessation interventions. In those offering interventions, there is a wide variation in the availability and quality of programs across the labour force.

Smaller businesses (those with fewer than 50 employees) are much less likely than larger organizations to pursue smoking cessation efforts. Worksites with predominantly blue-collar workers and with union involvement are also underrepresented with respect to smoking cessation activities.

Furthermore, employers are twice as likely to provide information about tobacco as they are to offer smoking cessation programs. While this may give the appearance of action, we know from the research that the provision of information — in the absence of programs and a supportive environment — has a rather limited impact on behaviour change.

Research and literature reviews which have helped to shape Health Canada's Tobacco Demand Reduction Strategy show that there is significant value in workplace efforts addressed at smoking. The workplace is a key area for tobacco control for several reasons:

• It is a powerful setting for policy to protect workers from the effects of secondhand smoke.
• It provides a highly accessible and potentially effective setting for smoking cessation programs reaching large numbers of people.
• The costs of tobacco use to the employer (as noted above) create the potential for direct incentives and a win-win collaboration between employer and employees.

Health promotion surveys show a considerable readiness among smokers to kick the habit, an expressed desire for employer support for cessation programs and a reduced level of smoking where restrictions are in place. Employers who build on these attitudes and trends and implement effective policies and programs will make an important contribution to the health of their employees. At the same time, they can look forward to a healthier bottom line.