Bright Spot: Reducing Tobacco Use and Secondhand Smoke Exposure: Smoke-Free Policies

Photo by Mathew MacQuarrie on Unsplash

This bright spot was originally published in the 100 Million Healthier Lives Change Library and is brought to you through partnership with 100 Million Healthier Lives and the Institute for Healthcare Improvement.


Detailed Description

A smoke-free workplace is one of the most effective and lasting approaches to reducing employee tobacco use and eliminating non-smoking employees' exposure to secondhand smoke. Tobacco-free workplaces save lives and save money by:

  • Protecting the health of all workers
  • Supporting employees who are trying to quit smoking or smoke less
  • Reducing maintenance and health care insurance costs
  • Preventing nonsmokers from starting to smoke
  • Attracting nonsmokers to your work force

Expected Outcomes

  • Going smoke free lowers the risk of fires and accidental injuries, which can reduce insurance costs
  • Maintenance costs are higher in buildings that allow smoking than in buildings that are smoke-free
  • Employers in the US could save $4 to $8 billion in building operations and maintenance costs if they implemented comprehensive smoke-free indoor air policies, according to the EPA

Key Lessons Learned

A worksite may adopt a smoke-free policy alone or in combination with additional interventions to support tobacco-using employees who might seek assistance in quitting. These additional interventions include the following:

  • Tobacco cessation groups
  • Client educational materials or activities
  • Telephone-based cessation support
  • Counseling and assistance from healthcare providers
  • Access to effective pharmacologic therapies

Cost Details

As of May 2014, the Reducing Tobacco Use and Secondhand Smoke Exposure: Smoke-Free Policies program is offered at no cost. For the latest cost details, please contact the Reducing Tobacco Use and Secondhand Smoke Exposure: Smoke-Free Policies program directly.


A review of economic effectiveness of this intervention was conducted. Studies included in this review demonstrated a range of outcomes. An assessment of a smoke-free workplace policy found a cost of $526 per quality of life adjusted year (QALY) compared to a cost of $4613 per QALY for a free nicotine replacement therapy program (one study). There is a collective net benefit from smoke-free policies ranging from $48 billion to $89 billion per year in the United States (one study from 1994). A smoke-free workplace policy could prevent about 1500 heart attacks and 350 strokes in one year with approximately $55 million in direct medical cost savings (one study). An employer could potentially save $10,246 per year for every smoker who quits due to a smoke-free workplace policy (one study). Reducing tobacco use and secondhand smoke exposure: smoke-free policies (abbreviated).

Policies, Laws and Regulations

North Carolina laws don't address employer policies on smoking in the workplace. Local laws regulating smoking -- at the city, county, or town level -- may require employers to have a policy on smoking in some areas. And even though it's not required by law in North Carolina, employers are generally free to adopt tobacco policies in the workplace if they choose to. North Carolina does not require employers to create designated smoking areas or provide other accommodations for smokers in the workplace. North Carolina also doesn't specifically require employers to provide workplace accommodations for nonsmoker employees.

Possible tobacco cessation incentives, such as support groups, nicotine replacement therapies, educational information, etc.

Outcome Measures

Increased tobacco cessation among employees

Process Measures

Number of local businesses adopting the tobacco-free and smoke-free policy