One of the most serious occupational safety and health hazards of our time – smoking is slowly but surely drifting out of the workplace. On this year's World No Tobacco Day (31 May), the ILO has issued a new study ( Note 1) providing a global overview of anti-smoking efforts in the world of work, where we stand and increasingly – where we can't smoke at work.
Despite the clearly established link between tobacco smoking and cancer, some intrepid smokers still claim their human rights are assailed by efforts to ban their habit. A ban on smoking by municipal workers, whether at work or not in the small Norwegian town of Levanger raised outrage and prompted a local court to rule that smoking while working was a basic human right. Still, Norway is to introduce new anti-smoking laws on 1 June stubbing out smoke in restaurants and surveys show that 59 per cent favour of the measures.
Despite the Norwegian anomaly, non-smokers are slowly but surely getting the upper hand. An Irish ban on smoking in workplaces sparked some predictably colourful opposition, but stiff fines for miscreants and a visible policing of the ban seem to be working.
Still, Europe lags far behind North American efforts to clear the cloud of potentially deadly smoke. A Florida referendum in 2002 illustrated the importance Americans attach to a smoke-free environment with an overwhelming 70.8 per cent voted for a constitutional amendment prohibiting smoking in enclosed indoor workplaces, including restaurants. In doing so, Florida joined California, Maine, Utah and Vermont as well as cities such as New York and Boston, which have passed similar laws.
The world may not be far behind. A new study by the ILO's SafeWork programme, entitled Workplace Smoking shows that attitudes towards smoking are changing all over the world, although many workers still face a long road to clean air where they work, especially in the hospitality industry.
"We are dealing with one of the most serious occupational safety and health hazards of our time", says Carin Hakansta, author of the report. "The negative health effects of smoking and passive smoking have become common knowledge in many parts of the world."
Non-smokers breathe in the same toxic chemicals in tobacco smoke as the smokers do, with similar, although smaller effects. While most discussion about passive smoking have concentrated on lung cancer and breathing, the effects on heart disease are more important. According to the World Health Organization (WHO), there are about 15 times more deaths from heart disease caused by passive smoking – 35,000-62,000 deaths annually in the US – as lung cancer.
Many employers, especially in larger enterprises, now consider a smoke-free environment a serious issue. The study cites examples of salary initiatives for workers who kick the habit and workplace "non-smoking marshals" enforcing the ban. Trade unions, especially in the hospitality industry, show increasing interest in protecting their members against "passive" or "second hand" smoke.
Finally, governments are increasingly institutionalizing strategies to reduce smoking through legislation, national programmes, coordination bodies and massive campaigns. Iran's effective smoke-free programme is said to have cut smoking prevalence from 14.6 per cent in 1991 to 11.7 per cent in 1999.
A mixed reaction?
Nevertheless, despite strong arguments for smoke-free environments, smoking isn't always a priority issue for governments. This is particularly true in developing countries, where health budgets are too small and the competition too stiff between with serious illnesses such as malaria and HIV/AIDS. In tobacco-producing countries, especially in Africa, regulation of smoking risks becoming a conflict of interest with tobacco exports as an important earner of foreign exchange and source of employment.
This, despite the fact that the economic burden of smoking is often heavier for those who need their income most. In poor countries, the portion of scarce income spent on tobacco products could be spent for essential commodities such as food, clothes or school fees. The study cites a survey of rickshaw pullers in Dhaka, Bangladesh, who spend up to 40 per cent of their income on smoking while smokers in Minhang, China, spend as much as 60 per cent of their annual income on cigarettes. According to the World Health Organization (WHO), which this year is focusing on smoking and poverty in its World No Tobacco Day campaign, this isn't limited to developing countries – a worker in Copenhagen had to work 23 minutes to buy an international brand of cigarettes, while a worker in Nairobi, Kenya, needed 158 minutes.
Six steps to a smoke-free workplace
Citing examples from all over the world, the ILO study identifies six elements in achieving smoke-free workplaces:
- Innovative partnerships: Under the "California Coalition" the hospitality industry joined forces with the trade unions lobbying California's Smokefree Workplace Law adopted in 1995. In other countries, religion may play an important role. Bhutan considers smoking a sin and has made a commitment to WHO to become the first country to be completely tobacco free. A regional conference held in 2002 to discuss Buddhism and tobacco control included monks from Cambodia, Thailand and Sri Lanka.
- Smoking as an occupational safety and health issue: The national occupational safety and health authorities in the United States, Australia and the Canadian province of British Columbia acknowledged the problem of smoking at work.
- Information and communication: A survey of non-smokers' protection in restaurants and bars in five European countries (Finland, Belgium, France, Germany and Spain) carried out in 2003 illustrated the importance of a good communication strategy for successful implementation of legislation – 98 per cent of interviewees in Finland but only 73 per cent of interviewees in France were aware of the existence of an anti-smoking law in the country.
- Concrete guidelines: The study analysed 18 guidelines to smoke-free workplaces.
- Workplace assistance programmes: In Norway, the government offers a national programme of smoking cessation and prevention. Many Polish employers add motivating bonuses to the regular salaries to workers who try to quit smoking. Besides economic sanctions, Italian employers are discouraging workers from smoking by removing ash trays from corridors, placing warning notices, and appointing a "non-smoking marshal" on every floor of some buildings.
- A comprehensive and dynamic process involving trade unions and all the relevant sections of the enterprise or organization when developing a policy on smoking.
Note 1 - "Workplace Smoking - A Review of National and Local Practical and Regulatory Measures", by Carin Håkansta, International Labour Office, 2004.