The National Institute for Occupational Safety and Health (NIOSH) has just announced the availability of a draft Current Intelligence Bulletin (CIB) entitled Promoting Health and Preventing Disease and Injury through Workplace Tobacco Policies, for public comment.

NIOSH had previously published two Current Intelligence Bulletins devoted to tobacco use. The first one CIB 31: Adverse Health Effects of Smoking and the Occupational Environment, Publication Number 79–122, outlined several ways in which “smoking interacts with other workplace exposures to increase risk of disease and injury among workers.” The second, CIB 54: Environmental Tobacco Smoke in the Workplace, Publication No. 91–108, focused on secondhand smoke in the workplace as a cause of cancer and cardiovascular disease. That document recommended “eliminating tobacco smoking in the workplace as the best preventive approach.”

According to NIOSH, the draft CIB reflects a “strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance health and well-being.” NIOSH notes that smoking rates among “blue-collar workers have been shown to be consistently higher than among white-collar workers.” Among blue-collar workers, those exposed to higher levels of workplace dust and chemical hazards are more likely to be smokers. “Also, on average, blue-collar smokers smoke more heavily than white-collar smokers.”

The draft CIB indicates that smoking prevalence varied widely by industry, “ranging from about 10% in education services, to more than 30% in construction, mining, and accommodation and food services. Smoking prevalence varies even more by occupation, ranging from 2% among religious workers to 50% among construction trades helpers.

In the employment context, specific toxic chemicals associated with work processes in some workplaces are also present in tobacco products and tobacco smoke, increasing exposure to those chemicals among tobacco-using workers and workers exposed to secondhand smoke. “The overall effect of these combined exposures can be additive…, or, in some cases, synergistic.” Even without environmental exposure to tobacco and secondhand smoke, or the causing of explosion or fire, “any form of tobacco use may result in traumatic injury if the worker operating a vehicle or industrial machinery is distracted by tobacco use.”

For employers, the CIB reminds that employer responsibilities established in federal, state, and local laws and regulations, as well as health and economic considerations, can motivate employers to establish workplace policies that prohibit or restrict tobacco use in the workplace. For example, “the general duty of employers to provide safe work environments for their employees can motivate employers to prohibit smoking in their workplaces, thereby avoiding liability for exposing nonsmoking employees to secondhand smoke.”

The draft states that some employers have taken action to extend restrictions on tobacco use by their employees beyond the workplace, by “prohibiting smoking by workers during their workday breaks, when away from the workplace, including during lunchtime.” It suggests that several large employers have even barred the hiring of smokers. Such wide-ranging policies generate substantial controversy and may be illegal in some jurisdictions based on state-specific “off-duty conduct” statutes.

In the draft CIB, NIOSH recommends that employers:

  • Establish and maintain tobacco-free workplaces for all employees, allowing no use of any tobacco products, including but not limited to cigarettes, cigars, pipes, and smokeless tobacco products by anyone at any time in the workplace;
  • Assure compliance with current OSHA and MSHA regulations prohibiting or limiting smoking, smoking materials, and/or use of other tobacco products in work areas characterized by the presence of explosive or highly flammable materials or potential exposure to toxic materials;
  • Provide information on tobacco-related health risks and on benefits of quitting to all employees and other workers on a regular basis;
  • Provide information on employer-provided and publically available tobacco cessation services to all employees and other workers on a regular basis;
  • Offer and promote more comprehensive tobacco cessation support to all tobacco-using workers and, where feasible, to their dependents;
  • Become familiar with available guidance before developing, implementing, or modifying tobacco-related policies, interventions, or controls;
  • Develop, implement, and modify tobacco-related policies, interventions, and controls in a stepwise and participatory manner—with input from employees, labor representatives, line management, occupational safety/health and wellness staff, and human resources professionals; and
  • Make sure that any differential employment benefits policies that are based on tobacco-use or participation in tobacco cessation programs are designed with a primary intent to improve worker health and comply with all applicable federal, state, and local laws and regulations. Even when permissible by law, these differential employment benefit policies, as well as differential hiring policies based on tobacco use, should be implemented only after serious consideration is given to ethical concerns and possible unintended consequences, including the potential for adverse impacts on individual employees (e.g., coercion, discrimination, and breach of privacy) and the workforce as a whole.

Public comments on the draft CIB may be submitted to docket number CDC-2014-0013, and are due on September 15, 2014.