Progress in Chronic Disease Prevention Survey of Worksite Smoking Policies -- New York City

In August 1986, the New York City (NYC) Department of Health conducted a telephone survey on worksite smoking policies in private NYC businesses. The survey was conducted to assess the status of worksite smoking policies in the city and to gather baseline data for evaluating the impact of policies restricting workplace smoking.

A sample of companies was obtained from the 1985 Dun and Bradstreet Corporation listing of 172,000 businesses that had applied for a credit rating sometime in the past. Because about half of all NYC employees work for companies with less than or equal to 10 employees (New York State Department of Labor, unpublished data), an equal number of companies with less than or equal to 10 employees and companies with 10 employees were sampled. Businesses were selected randomly from these two groups to produce a total sample of 1,130 companies.

The telephone survey was conducted during a 3-week period in August 1986 by six Health Resource Coordinators employed and trained by the NYC Department of Health. The coordinators interviewed the company employee designated by the telephone respondent as the person most likely to be familiar with a worksite smoking policy.

Of the 1,130 businesses in the sample, 770 had working telephones with the correct telephone number available. Of these, 573 (74.4%) agreed to participate in the survey. Most companies responding to the survey had 100 employees (Table 1). The distribution of respondents, by type of company, was as follows: 33.5%, trade; 27.7%, services excluding health care; 16.8%, manufacturing; 10.5%, finance, insurance, or real estate; 6.3%, transportation, communication, or utility; 2.8%, construction; and 2.4%, health care.

Twenty-four companies (4.2%) reported that they had a written smoking policy. Another 17 (3.0%) said that they planned to adopt a written policy within the next 12 months, and 33 (5.8%) said that they were considering developing a smoking policy. Of the 24 companies with a written smoking policy, nine (37.5%) had adopted the policy within the past 12 months.

Companies with more employees were slightly more likely to have a written smoking policy (Table 1). The proportion of companies with a written smoking policy ranged from 7.3% for manufacturing companies to 0% for construction companies and for the category including transportation, communication, and utility companies. The proportion of companies with a written smoking policy varied with the smoking status of the company's administrator. Of companies whose administrator was a current smoker, 2.7% (5/185) had a written smoking policy, compared with 5.6% (18/319) of companies whose administrator did not smoke (p = 0.09, Fisher's Exact test). A 1979 survey of smoking policies in hospitals found a similar association between the smoking status of the administrator and the sale of cigarettes on hospital premises (1).

The proportions of all companies (those with and without a written smoking policy) banning or restricting smoking in various settings were as follows: 84.0%, storage areas for hazardous or flammable materials; 79.9%, elevators; 57.7%, areas with electronic instrumentation or computers; 57.3%, manufacturing or assembly areas; 38.0%, stairways; 28.0%, corridors; 25.8%, open work areas with desks; 23.7%, shared offices; 23.3%, cafeterias or dining rooms; 20.9%, lobbies or waiting areas; 20.7%, private offices; 19.3%, lounges; 18.7%, meeting or conference rooms; and 14.8%, restrooms.

The proportion of companies restricting smoking in open work areas (25.8%) varied by type of company and smoking status of the company's administrator. Health care companies were more likely to restrict smoking in open work areas (61.5%), whereas transportation, communication, and utility companies were less likely to have such restrictions (6.5%) (p 0.01). Companies whose administrator was a smoker were less likely to restrict smoking in open work areas (18.0%) than were companies whose administrator did not smoke (31.7%)(p = 0.002). Reported by: V Todaro, MPH, KJ Denard, MS, P Clarke, MPH, MK Bradstock, MD, MPH, Div of Health Promotion, SC Joseph, MD, MPH, New York City Dept of Health. Office on Smoking and Health, Div of Health Education, Center for Health Promotion and Education; Office of the Director, Epidemiology Program Office; Div of Environmental Hazards and Health Effects, Center for Environmental Health, CDC.

Editorial Note

Editorial Note:The control of smoking in the workplace and in public places has received increasing attention in recent years as the hazards of exposure to environmental tobacco smoke (ETS) have been documented. The Surgeon General's 1986 report on the health consequences of involuntary smoking concluded that: 1) involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers; 2) children of parents who smoke have an increased frequency of respiratory illness compared with children of nonsmoking parents; and 3) the simple separation of smokers and nonsmokers within the same air space may reduce, but does not eliminate, the exposure of nonsmokers to ETS (2).

For adults living in a household where no one smokes, the workplace is the greatest source of ETS exposure. As a result, the workplace has become the focus of particular attention. State legislation restricts smoking in the workplace for public-sector employees in 22 states and for private-sector employees in nine states. These laws vary considerably in their comprehensiveness: they may contain provisions to require a written policy (five states), limit smoking to designated areas (eight states), require the posting of signs (10 states), and give preference to nonsmokers in resolving conflicts over the designation of a work area (two states) (2). On February 6, 1987, the New York State Public Health Council adopted a statewide regulation that will restrict smoking in the workplace; the regulation is scheduled to take effect on May 7, 1987.

Recent national surveys have shown that 35% to 40% of private-sector businesses restrict or ban smoking in the workplace (2). Most of these surveys have included primarily companies with greater than or equal to 100 employees. On the other hand, in the NYC survey, only 4.2% of companies had a written smoking policy, and 25.8% restricted smoking in open work areas. The prevalence of smoking restrictions in this sample may be lower because most of the companies surveyed were small (94% with 100 employees, 45% with less than or equal to 10 employees). Within this sample of small businesses, the likelihood of having a written smoking policy increased as the number of employees increased. Two other surveys have found a positive association between the number of employees and the likelihood of having smoking restrictions (National Interagency Council on Smoking and Health, unpublished data) (3).

Small companies may be less likely to restrict smoking in the workplace for several reasons. Employees of small companies may more easily resolve smoking-related disputes on their own; they and their employers may believe that smoking policies are unnecessary. On the other hand, employees of small companies may favor smoking restrictions but may be more reluctant to complain about smoking in the workplace because of their closer working relationship with the employer and fellow employees. Finally, restricting smoking in the workplace may involve greater logistical obstacles for small companies than for larger ones.

Several public opinion polls have shown strong support, among both smokers and nonsmokers, for restricting smoking in the workplace and in public places. Although only a few studies have evaluated the impact of worksite smoking restrictions, workplace smoking policies appear to improve air quality, are met with good compliance, and are generally well accepted by both smokers and nonsmokers. Policies restricting smoking appear to be followed by a decrease in smokers' cigarette consumption at work and an increase in enrollment in company-sponsored smoking cessation programs (2). Policies may also have positive economic effects for employers because the excess annual cost to a company per smoking employee is conservatively estimated at $300 to $600 (4).

In the preface to his report on the health consequences of involuntary smoking, the Surgeon General stated, "The scientific case against involuntary smoking as a health risk is more than sufficient to justify appropriate remedial action, and the goal of any remedial action must be to protect the nonsmoker from environmental tobacco smoke" (2). Such remedial action should apply to companies of all sizes. Small companies should be included for two reasons: 1) a large percentage of the workforce is employed by small companies and 2) small companies appear to be less likely to restrict smoking in the workplace.

References

1. Kelly NR, Cohen FL. Smoking policies in U.S. hospitals: current status. Prev Med 1979;8:557-61.

2. Office on Smoking and Health, CDC. The health consequences of involuntary smoking: a report of the Surgeon General. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, 1986; DHHS publication no. (CDC)87-8398:259-322.

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