A new report from the National Institute for Occupational Safety and Health (NIOSH) recommends that all workplaces become tobacco-free and that employers make tobacco cessation programs available to workers. These latest recommendations, which also encompass the use of Electronic Nicotine Delivery Systems (ENDS)—or e-cigarettes—are aimed at protecting workers from the occupational hazards of tobacco and the effects of secondhand exposure to tobacco smoke and emissions from e-cigarettes.

Preventing occupational illness

NIOSH's recommendations, which were issued in a technical document called a Current Intelligence Bulletin (CIB), build upon previous recommendations regarding tobacco use in the workplace and incorporate public review and comment on an earlier draft document. The report is aimed at preventing occupational injury and illness related to tobacco use, while also improving the general health and well-being of workers.

“This Current Intelligence Bulletin marks a half century since the first Surgeon General’s Report on the health consequences of smoking. While cigarette smoking in the U.S. has declined more than 50% among all U.S. adults since then, about 20% of all U.S. workers still smoke and far too many nonsmoking workers are still exposed to secondhand smoke at work,” said NIOSH Director John Howard, M.D. “These new recommendations are an important step in reducing the number workers who still face the risks associated with tobacco while on the job.”

First time for e-cigarettes

This report is the first NIOSH guidance to include recommendations on e-cigarettes. Because of the limited data available on the safety of exposure to e-cigarette emissions, NIOSH recommends that these products are included in indoor smoking bans.

NIOSH also recommends that employers incorporate tobacco cessation support programs into a more comprehensive approach that addresses the overall safety, health, and well-being of workers. The recommendations  outlined in the new CIB will not only prevent occupational injury and illness related to tobacco use, but, in keeping with the philosophy of  the NIOSH Total Worker Health™ Program, will  also  improve the general health and well-being of workers.

NIOSH recommends that employers take the following actions related to employee tobacco use:

• At a minimum, establish and maintain smoke-free workplaces that protect those in workplaces from involuntary, secondhand exposures to tobacco smoke and airborne emissions from e-cigarettes and other electronic nicotine delivery systems. Ideally, smoke-free workplaces should be established in concert with tobacco cessation support programs. Smoke-free zones should encompass (1) all indoor areas without exceptions (i.e., no indoor smoking areas of any kind, even if separately enclosed and/or ventilated), (2) all areas immediately outside building entrances and air intakes, and (3) all work vehicles. Additionally, ashtrays should be removed from these areas.
• Optimally, establish and maintain entirely tobacco-free workplaces, allowing no use of any tobacco products across the entire workplace campus.
• Comply with current OSHA and MSHA regulations that prohibit or limit 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. To the extent feasible, follow all similar NIOSH recommendations.
• Provide information on tobacco-related health risks and on benefits of quitting to all employees and other workers at the worksite (e.g., contractors and volunteers).
• Provide information on employer-provided and publically available tobacco cessation services to all employees and other workers at the worksite.
• Offer and promote comprehensive tobacco cessation support to all tobacco-using workers and, where feasible, to their dependents. Provide employer-sponsored cessation programs at no cost or subsidize cessation programs for lower-wage workers to enhance the likelihood of their participation.
• Develop, implement, and modify tobacco-related policies, interventions, and controls in a stepwise and participatory manner. Get input from employees, labor representatives, line management, occupational safety/health and wellness staff, and human resources professionals.
• 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.

All workers, including workers who use tobacco and nonsmokers exposed to secondhand smoke at their workplace should know the occupational safety and health risks associated with their work, including those that can be made worse by personal tobacco use, and how to limit those risks.

Current Intelligence Bulletin 67: Promoting Health and Preventing Disease and Injury Through Workplace Tobacco Policies is available at http://www.cdc.gov/niosh/docs/2015-113/.

NIOSH is the federal agency that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. For more information about NIOSH visit http://www.cdc.gov/niosh/.