Tobacco: Addiction and Embarrassment

Working with employees and their spouses in an employer-sponsored tobacco cessation program is an eye-opener for even the most experienced wellness coach. The most reoccurring theme is the embarrassment expressed by participants who are still smoking cigarettes, especially now that society has "ostracized" their practice.


"I am ashamed and embarrassed that I have an addiction that I cannot control," said one employee, who chews 10 tins of tobacco each week. "I am a fool to let something control my mind like tobacco." Aggressive intervention and employer-sponsored and supportive work-site policies can increase successful tobacco cessation. Tobacco use increases the utilization of healthcare services, which translates into higher claims for employers to incur.

On the other hand, non-tobacco users have increased productivity and reduced absenteeism. Some facts:

  • Cigarette smoking is the number one cause of preventable disease and death worldwide;
  • Cigarette smoking is responsible for more than 480,000 deaths per year in the United States including an estimated 41,000 resulting from secondhand smoke exposure;
  • One in five deaths annually, or 1,300 deaths every day, are attributed to smoking;
  • Total economic cost of smoking is more than $300 billion a year including nearly $170 billion in direct medical care for adults;
  • More than $156 billion in lost productivity due to premature death and exposure to secondhand smoke.

Employers should take notice when the smoke clears. An Ohio State University study suggests that U.S. businesses pay almost $6,000 per year extra for each employee who smokes compared to the cost to employ a person who has never smoked cigarettes. A large aspect of tobacco cessation is emotional.


Coaches excel at this often overlooked aspect and can assist in overcoming the emotional barriers of denial, anger, and realization -- something technology has difficulty addressing. Smoking is a very "personal habit." Everyone has personal stories that are real and honest.


A coach needs to remain non-judgmental, open and willing to listen rather than coerce behavior. Some days, tears are shed for smokers and with them. The coach has the opportunity to accompany smokers on the road to realizing their addiction, in many cases, is just a really bad habit. At the initial interview, the wellness coach needs to "get into heads," of smokers; to learn their lifestyles and what makes them tick.


This session can open doors for the coach to approach and guide a participant to do what is best. Cessation doesn't stop smoking completely, but does provide participants an avenue to open up their minds to their addiction and to what they want to accomplish. A coach's role is not to judge, but to help participants develop ways to overcome their addiction. Coaches can never lose sight that smoking is an addiction.


Anyone can easily admit to being a smoker, but fewer can accept that they are addicted. Herein lies an obstacle. The first step for the coach is to know the participant. The role of the coach and the personal goals set are specific to each participant. All participants have different levels of acceptance and need varied degrees of support.


A coach learns what makes smokers tick, the lifestyle they lead, and where they want their lives to lead to. A coach needs to determine how best to help smokers stay focused to achieve their goals. All smokers have different reasons to stop. Many are attending an employer-sponsored tobacco cessation program because of a financial incentive.


Others are extremely motivated. They really want to cut back or quit, but have been unsuccessful. Hopefully, by attending smoking cessation programs, enough information will be disseminated to motivate employees to attempt to quit and overcome the embarrassment of tobacco use.


About the Author

Karen L. Andalman, CWC, is the president and founder of WellChoice, Inc., a leader in corporate wellness coaching, risk management and wellness incentive programs, biometric screening events, tobacco cessation programs, disease management, on-site/ near-site clinic wellness programs, case management and utilization management programs.