Smoking in construction: how can employers help staff quit?

Official figures show that the number of smokers in the UK has steadily declined over the past three decades.

The implementation of smoke-free legislation and an increase in the legal age for tobacco purchase from 16 to 18 years in 2007 had an immediate impact on the number of smokers across the nation. Whereas 27% of adults in the UK smoked in 1993, only 16% did so in 2019.

However, the number of smokers remains high in the construction sector, where 28% of people smoke, according to the latest data available from the British Heart Foundation.

Additionally, more than one in five manual workers in England smoke, the Office for Health Improvement and Disparities found – a number that is three times higher than in other professions.

There are a few reasons why smoking rates are higher in construction, says Hazel Cheeseman, deputy chief executive at Action on Smoking and Health (ASH), a campaigning public health charity founded in 1971 by the Royal College of Physicians to end smoking.

Construction is a sector in which demographic groups who are more likely to smoke are overrepresented, including men, manual workers and people who grew up in countries where smoking is more common, such as Central and Eastern Europe.

Another element that may contribute to the higher number of smokers in construction is what Cheeseman calls “an opportunity factor” associated with break times, making it easier for construction workers to light a cigarette than those who are based in an office.

“If you are a smoker who works in the office, you’ve got to put your coat on, go outside, stand in the rain, smoke your cigarette and go back inside,” Cheeseman tells CIOB People.

“But if you work in construction, you’re often already outside. Even if you are on site, where smoking is not allowed, moving off site is easier.”

A common reason many smokers give as to why they struggle to quit is that the act of smoking provides them with an opportunity to step away from work and take a break.

The slowing down of breathing and incidental conversations with smoking partners is a routine that can become very difficult to give up, especially in a high-pressure environment such as construction.

“That’s a really important part of people’s coping mechanisms,” Cheeseman says, adding that smoking is more prevalent among individuals who have poor mental health.

However, she insists, when people stop smoking, not only does their physical health improve but also their mental wellbeing.

“[It] doesn’t matter whether you have a pre-existing mental health condition or not, on average every smoker sees an improvement in their mental health when they quit,” she says.

“Smoking makes such a profound impact on your body that it’s not surprising it also impacts your brain.”

Employers can play a vital role in this area by facilitating spaces and opportunities where staff can step away from work that is not linked to smoking breaks, such as introducing talking or tea breaks.

Being part of a team where the majority smokes can be challenging for those trying to quit – but it can also provide encouragement.

“A group that contains a lot of smokers might undermine your chances of quitting,” Cheeseman adds.

“The other side of the coin is a group of co-workers who are trying to quit together – that’s often successful because you are doing it together and supporting each other.”

Cheeseman says there is an opportunity for employers to incentivise programmes among groups of workers who want to quit together.

For example, employers can allow staff to take time off to access support and bring in smoking cessation experts to provide advice.

She continues: “If employers are interested in providing more active support to their employees, they should get in touch with their local public health team and find out what’s available in their area.”

Tracy Parr, programme director for the London Tobacco Alliance and Stop Smoking London, says that HR departments and site managers can be instrumental in supporting staff who want to quit.

“The best way to do this is through regular and very brief advice provided to staff who smoke,” Parr tells CIOB People.

“Training on very brief advice, which can be delivered in under 30 seconds, is available through the National Centre for Smoking Cessation and Training.”

Parr claims that smokers are three times as likely to successfully quit smoking when they combine behavioural support with proven stop-smoking tools such as nicotine replacement and vaping.

Behavioural support includes counselling sessions or information about how and why to stop smoking and can be accessed online, by telephone or through local support groups in the NHS, some pharmacies or specialist websites.

Cheeseman agrees with Parr that vaping can be a useful aid to support smoking cessation, but there are risks to consider.

The NHS does not recommend vaping to non-smokers and it can cause side effects, as well as having an environmental impact, but it can help smokers quit more effectively.

Earlier this year, the government introduced a national scheme by which it provides vape starter kits alongside behavioural support to one million smokers in the country.

“We know that people are much more likely to succeed if they get an alternative source of nicotine, be that through medication or an e-cigarette, combined with behavioural support,” says Cheeseman.

Companies can also buy app licences that can support staff 24 hours a day. A new app using artificial intelligence can detect when people are entering a place where they used to smoke and helps users manage triggers.

Another initiative that construction employers can introduce to support workers willing to quit or reduce smoking is gamification.

Sharing information across the company about the achievements and progress of staff trying to quit, celebrating successes and rewarding people quitting on different sites, can motivate others to follow suit and ensure that those trying to quit do it permanently.

“There are opportunities for employers here to create environments that are more likely to support quitting rather than to support smoking,” Cheeseman continues.

Although employers might be wary of the financial implications of introducing stop-smoking support and incentives, including giving people time off to access services, Cheeseman says that failing to support staff could prove more costly in the long term.

“Smoking is so damaging to your body that it’s going to exacerbate any other illness that you might have, even if that’s not smoking related,” Cheeseman concludes. “There’s a solid financial reason why employers might want to support more of their staff to quit smoking.”