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Tobacco Use Cessation Evaluation Measures

Once a company has conducted assessment and planning for tobacco-use cessation programs, and developed the specific tasks of implementation for these programs, it is time to develop the evaluation plan. This evaluation plan should be in place before any program implementation has begun.

Metrics for worker productivity, health care costs, heath outcomes, and organizational change allow measurement of the beginning (baseline), middle (process), and results (outcome) of workplace health programs. It is not necessary to use all these metrics for evaluating programs. Some information may be difficult or costly to collect, or may not fit the operational structure of a company. These lists are only suggested approaches that may be useful in designing an evaluation plan.

These measures are designed for employee group assessment. They are not intended for examining an individual’s progress over time, which would raise concerns of employee confidentiality. For employer purposes, individual-level measures should be collected anonymously and only reported (typically by a third party administrator) in the aggregate, because the company’s major concerns are overall changes in productivity, health care costs, and employee satisfaction.

In general, data from the previous 12 months will provide sufficient baseline information and can be used in establishing the program goals and objectives in the planning phase, and in assessing progress toward goals in the evaluation phase. Ongoing measurements every 6 to 12 months after programs begin are usually appropriate measurement intervals, but measurement timing should be adapted to the expectations of the specific program.

Tobacco use is the leading cause of preventable illness and death in the United States. Recognized as a cause of multiple cancers, heart disease, stroke, complications of pregnancy, and chronic obstructive pulmonary disease (COPD), tobacco use is responsible for 443,000 deaths per year.1 Tobacco-use cessation improves health by lowering an individual’s risk of developing tobacco-related diseases such as heart disease, stroke, and cancer.

Tobacco use affects productivity and absenteeism, increases use of disability leave, and increases overall health care costs among workers.

  • Tobacco use costs an estimated $96.8 billion per year in lost productivity due to sickness and premature death1
  • Studies have shown that men who smoke use 4 more sick days per year than nonsmoking men, and women who smoke use 2 more sick days per year than nonsmoking women2
  • Of the U.S. adults who smoke, men incur $15,800 and women incur $17,500 more in lifetime medical expenses than men and women who do not smoke (in 2002 dollars)3

The Introduction to Process Evaluation in Tobacco Use Prevention and Control was published in 2008 by the Centers for Disease Control and Prevention (CDC). It applies the standards CDC program evaluation framework (engage stakeholders, describe program, focus evaluation plan, gather credible evidence, justify conclusions and recommendations, and ensure use of recommendations) to tobacco programs. It emphasizes process measures, which determine whether the program is operating efficiently, versus outcome measures, which assess whether the program is having an effect on health.

References

1.  Centers for Disease Control and Prevention. Smoking-attributable mortality, years of potential life lost, and productivity losses – United States, 2000-2004. Morbidity and Mortality Weekly Report 2008; 57(45): 1226-1228.

2.  Warner KE, Smith RJ, Smith DG, Fries BE. Health and economic implications of a work-site smoking-cessation program: a simulation analysis. J Occup Environ Med. 1996; 38(10): 981-992.

3.  Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost, and economic costs – United States, 1997-2001. Morbidity and Mortality Weekly Report 2005; 54(25): 625-628.

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