M13: Tobacco Prevention and Cessation

(3 points)

INTENT

Reduce the use of tobacco through interventions that prevent tobacco use and support tobacco cessation among current tobacco users. 

SUMMARY

This WELL feature requires employee access to tobacco cessation support programs such as counseling, prescription, over-the-counter tobacco cessation medications and nicotine replacement products. It also promotes prevention programs, such as a ban on the sale of tobacco within the project boundary and education on the health consequences of tobacco use. 

ISSUE

The World Health Organization estimates that globally over 1.1 billion people smoked tobacco in 2015, and by 2025, the global prevalence of tobacco smoking will be an estimated 19%. Tobacco remains the only legal drug that can cause death when used as intended by manufacturers, is responsible globally for an estimated six million deaths per year among direct users, and serves as the cause of death for up to half of its users. In addition to those deaths caused by direct use, an estimated 890,000 annual deaths can be attributed to non-user exposure to second-hand smoke. By 2020, it is predicted that tobacco will account for 10% of all deaths worldwide, yet national comprehensive health services that fully or partially cover services to support tobacco cessation are available in only 24 countries, benefiting just 15% of the world’s population. In the workplace, employees that smoke incur greater absences, take more sick days and have higher health care costs than non-smoking employees. Additionally, 76.5 hours per year are lost in work productivity for smokers, compared to 42.8 hours for those who do not smoke, due to time taken for smoking breaks and smoking related illnesses.  

SOLUTIONS

Employers can play a key role in supporting employee tobacco cessation. Although 70% of U.S. adult smokers are interested in quitting and 40% of smokers attempt to quit each year, only 8% of smoking employees report that their workplace offers smoking cessation assistance. However, 74% of employees report the support of their employer was useful in their smoking cessation efforts. Research indicates that the majority of people do not know the specific health risks of tobacco use. For example, a 2009 survey in China indicated that only 38% of smokers knew that smoking causes coronary heart disease, and only 27% knew that it raises risk for strokes, underscoring the need for improved education regarding the risks of tobacco use, as awareness increases a current smoker’s desire to quit. Among those who attempt to quit, counseling and medication more than double the chance of quitting success. Another influencing factor on tobacco use is an individual’s proximity to outlets where it is sold. Restricting the sale of tobacco on-site is a key strategy for preventing or curbing use of tobacco products as well as providing support to those trying to quit.

IMPACT

Preventing initiation of tobacco use and supporting cessation among current users is critical in alleviating the significant burden of disease caused by tobacco. Combined, these strategies can play a key role in benefitting the short- and long-term health, well-being and productivity of employees.

REQUIREMENTS

Part 1

Promote Tobacco Prevention (1 point)

Verified by Policy Document, Educational Materials

For All Spaces

The following requirements are met:

1. The sale of tobacco products and e-cigarettes on project property is banned (e.g., through on-site vendors).

2. Education on the health consequences of tobacco is provided to all regular building occupants. 

Note: Education must be culturally appropriate and literacy level appropriate. Education can come in the form of trainings, brochures, videos, posters, pamphlets, newsletters and/or other written or online information. 

If the requirements of Part 1: Promote Tobacco Use Prevention are met through the provision of educational materials, then these can be counted toward Part 2: Promote Health and Wellness Education in Feature C01: Health and Wellness Awareness.

For WELL Core and MFR Certification, projects must make education available to all tenants.

Part 2

Support Tobacco Cessation (2 points)

Verified by Policy Document

For All Spaces

Information is available for all eligible employees about available programming, counseling and coverage related to tobacco cessation, including clear information about how to access these resources, in addition to at least four of the following requirements:

1. Resources referring tobacco users to tobacco cessation telephone quit lines or online quitting resources.

2. Tobacco cessation counseling covered at no cost or subsidized by at least 50%. Programs may be provided on- or off-site; in group or individual settings; and through vendors, on-site staff, health insurance plans or programs, community groups or other qualified practitioners.

3. Prescription tobacco cessation medications and nicotine replacement products (e.g., inhalers, nasal sprays, bupropion, varenicline) covered at no cost or subsidized by at least 50%.

4. Nationally-approved, over-the-counter nicotine replacement products (e.g., gum, patches, lozenges) covered at no cost or subsidized by at least 50%.

5. Incentive program for current tobacco users actively trying to quit.

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