Worker Productivity | Tobacco Use Cessation Evaluation Measures

Worker productivity measures for tobacco-use cessation1-8

Healthier employees are less likely to call in sick. Companies can sometimes assess sick day use as the most direct measure to determine whether health programs are increasing worker productivity.


  • Determine the average number of sick days per employee over the previous 12 months for tobacco-related illness
    • Tobacco use can result in increased employee sick days from a variety of illnesses. Some of the most useful illnesses to track short term are those related to the respiratory system, such as flu (influenza), bronchitis, and pneumonia. Longer term, cardiovascular disease, several forms of cancer, and chronic obstructive pulmonary disease (COPD) are all related to tobacco use. See health care and pharmaceutical claims assessment for methods to identify the frequency of these employee illnesses during the assessment phase
    • This measure may be less useful if there has been a large increase or decrease in numbers of employees over the past 12 months
  • Determine the costs of worker absenteeism including the costs of replacement workers, costs in training replacement workers, and loss and delay in productivity, for those who are on sick leave due to tobacco-related illnesses
  • Determine time employees spend during working hours participating in tobacco use-related worksite programs
  • Additional validated surveys have been developed to provide employers with information about the indirect costs of untreated or undertreated employee health issues related to tobacco use such as chronic obstructive pulmonary disease. Employers who use these health and productivity surveys on an ongoing basis can begin to evaluate the return on investment (ROI) of offering tobacco use cessation programs on employee absence or productivity. These surveys may be proprietary and may require a modest fee to use. Two examples are provided below:
    • Health and Work Performance Questionnaire (HPQ) is a short, easy to administer self-report survey designed to estimate workplace indirect costs (absenteeism, reduced productivity, and injury due to accidents) of employee health problems developed by the World Health Organization (WHO) and the Harvard Medical School
    • The Work Limitations Questionnaire (WLQ) developed by the Health Institute at Tufts Medical Center is an easy to use questionnaire that addresses general work limitations which can be built into other health assessment tools such as a health risk appraisal or employee health survey


  • Re-assess the average number of sick days per employee at the first follow-up evaluation
  • Periodic repeats of other baseline measures


  • Assess changes in the average number of sick days per employee in repeated follow-up evaluations
  • Assess changes in time employees spend during working hours participating in tobacco use-related worksite programs
  • Assess changes in costs from baseline

1.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.

2.  Centers for Disease Control and Prevention. Framework for program evaluation in public health. Morbidity and Mortality Weekly Report 1999;48(No. RR-11): 1-40.

3.  Goetzel RZ, Ozminkowski RJ. Program evaluation. In: O’Donnell MP, editor. Health promotion in the workplace, 3rd edition. Albany, NY: Delmar Thomson Learning; 2002. p 116-165.

4.  Centers for Disease Control and Prevention. Introduction to Process Evaluation in Tobacco Use Prevention and Control. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2008.

5.  Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, Pronk N, Simon G, Stang P, Ustun TB, Wang P. The World Health Organization Health and Work Performance Questionnaire (HPQ). J Occup Environ Med. 2003 Feb;45(2):156-174.

6.  Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, Stang PE, Ustun TB. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occup Environ Med. 2004 Jun;46(6 Suppl):S23-37.

7.  Wang PS, Beck A, Berglund P, Leutzinger JA, Pronk N, Richling D, Schenk TW, Simon G, Stang P, Ustun TB, Kessler RC. Chronic medical conditions and work performance in the health and work performance questionnaire calibration surveys. J Occup Environ Med. 2003 Dec;45(12):1303-1311.

8.  Lerner D, Amick BC 3rd, Rogers WH, Malspeis S, Bungay K, Cynn D. The Work Limitations Questionnaire. Med Care. 2001 Jan;39(1):72-85.