Implementing a Tobacco-Free Campus Initiative in Your Workplace
This toolkit provides guidance for implementing a tobacco-free campus (TFC) initiative that includes a policy and comprehensive cessation services for employees. It is based on the Centers for Disease Control and Prevention's (CDC) experience with implementing the U.S. Department of Health and Human Services (HHS) Tobacco-Free HHS initiative.
Worldwide, tobacco use results in nearly 5 million deaths per year. If current trends continue, it is predicted that tobacco use will cause more than 10 million deaths annually by the year 2020.1 Cigarette smoking remains the leading preventable cause of death in the United States and is responsible for an estimated 438,000 deaths per year, or about one out of every five deaths.2
Policies establishing smoke-free environments are the most effective way to reduce exposure to secondhand smoke. Evidence has shown that smoke-free policies in enclosed workplace settings are associated with reduced daily cigarette consumption among employees and possibly with increased cessation among employees.3
The benefits of smoke- or tobacco-free campus policies that also apply to outdoor workplace settings have been much less thoroughly researched, probably because these policies are a relatively new development. One recent study found that the implementation of a smoke-free campus policy in an office workplace that already had a smoke-free policy for indoor settings was associated with an increase in quit rates and a reduction in daily cigarette consumption among continuing smokers.4
Unlike smoke-free indoor policies, TFC policies are not solely designed to protect nonsmokers from secondhand smoke but rather are also intended to encourage employees to improve their health by quitting the use of tobacco products. Tobacco-free campuses create work environments in which tobacco users find it easier to reduce their consumption or quit altogether.5
Establishing a TFC provides employers with an opportunity to communicate a consistent pro-health message, project a positive image, and reduce tobacco-related health care costs. Providing cessation benefits (coverage for counseling and medications) in conjunction with the policy supports the quitting process.
CDC's TFC Policy Implementation
The vision of a tobacco-free CDC began at the request of CDC Director Julie Gerberding. In response to Dr. Gerberding's directive, the Healthier Worksite Initiative Advisory Committee formed the Tobacco-Free Campus Working Group, led by the Office on Smoking and Health. This team worked with Atlanta-area labor unions to implement a two-phase TFC plan: providing expanded tobacco use cessation services for CDC employees nationwide through the Office of Health and Safety clinics in phase one and establishing of completely tobacco-free CDC campuses wherever possible in phase two.
As a result of this initiative, the HHS Secretary announced in November 2004 that all HHS campuses would be going tobacco-free and that all HHS agencies would provide tobacco use cessation services to employees as part of the Tobacco-Free HHS initiative. CDC supported this effort with leadership and technical expertise. At this time, CDC also implemented the first phase and began offering free nicotine replacement medications to all interested federal employees.
In August 2005, CDC completed negotiations with Atlanta-area labor representatives, thereby enabling all CDC-owned property in the area, as well as that in other parts of the country not affected by current labor agreements, to go tobacco-free. CDC was among the first HHS agencies to implement Tobacco-Free HHS at multiple campuses across the United States.
This toolkit describes how others in federal or nonfederal workplaces can plan and implement a TFC policy and evaluate its success. The toolkit describes the following project phases:
For non-federal workplaces, consider these guidelines for a smoke-free workplace if your organization is unable to go tobacco-free. Executive Order 13058 made all federally-owned, leased, and rented Executive Branch facilities smoke-free in 1997. The 2006 Surgeon General's Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke found that workplace smoking restrictions reduce secondhand smoke exposure and smoking in the workplace.9
Note: this toolkit is simply an example of what was done at CDC. The examples and guidance provided should not be a substitute for working with your own internal policy and legal staff to develop appropriate guidelines and procedures for implementing a tobacco-free campus policy. Additionally, CDC and the Department of Health and Human Services (HHS) are in no way responsible or liable for guaranteeing the success of a tobacco-free campus policy established as a result of this toolkit.
1World Health Organization. The World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva, Switzerland: World Health Organization, 2002. Available at http://www.who.int/whr/2002/en/index.html.
2Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and productivity loses — United States, 1997-2001. MMWR 2005;54:625–628. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5425a1.htm.
3Glasgow RE, Cummings KM, Hyland A. Relationship of worksite smoking policy changes in employee tobacco use: Findings from COMMIT. Tobacco Control 1997;6(Suppl 2):S44–S48.
4Osinubi OYO, Sinha S, Rovner E, Perez-Lugo M, Jain NJ, Demissie K, Goldman M. Efficacy of tobacco dependence treatment in the context of a "smoke-free grounds" worksite policy: A case study. American Journal of Industrial Medicine 2004;46:180–187.
5Osinubi OYO, Slade J. Tobacco in the workplace. Occupational Medicine 2002;17(1):137–158.
6Stewart WF, Ricci JA, Chee E, Morganstein D. Lost productive work time costs from health conditions in the United States: Results from the American Productivity Audit. Journal of Occupational and Environmental Medicine 2003;45(12):1234–1246.
7Centers for Disease Control and Prevention. Cigarette smoking among adults — United States, 2000. MMWR 2002;51:642–645. Available at http://www.cdc.gov/mmwr/PDF/wk/mm5129.pdf [PDF-993k].
8Centers for Disease Control and Prevention. Cigarette smoking among adults — United States, 2004. MMWR 2005;54:1121–1124. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5444a2.htm.
9U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. Available at http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2006/index.htm.