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Smokers Seek Medical Help 50% More Than Nonsmokers, Surgeon General Says

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Times Staff Writer

Workers who smoke use the health care system up to 50% more than nonsmokers and may cost their employers as much as $500 a year each in excess expenses, according to the annual surgeon general’s report on smoking and health released Thursday.

“A smoking employee is a more expensive employee than a non-smoking employee,” Surgeon General C. Everett Koop said at a news conference. “The smoking employee uses the greater health dollar.”

Smokers bring higher health insurance costs for companies, increased absenteeism, more work-related accidents and disability reimbursement payments, not to mention “additional cleaning bills and destruction of desk tops, upholstery and carpeting,” Koop said.

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Smoke-Free Workplaces

He predicted increasing action in the coming years toward smoke-free work environments and said many companies already have initiated programs to eliminate smoking with “remarkable success.”

“If I had my way, I’d ban smoking--period,” Koop said, adding that he recognizes such a position is unrealistic.

He said he believes that a total ban “works better” in the workplace than segregating smokers and nonsmokers, but “it is up to the company to make its decision.”

Koop also said he thinks it is unfair to fire or discriminate against workers who already smoke. “That would be punishing a victim,” he said. “We cannot blame people for smoking. We should encourage them to give up smoking.”

Lung Risks

The report also said that for the majority of Americans, cigarette smoking “represents a greater cause of death and disability than their workplace environment,” and that the risks of chronic lung disease are dramatically higher for smokers who are also exposed to such occupational hazards as asbestos, cotton, coal and silica dust.

For example, the report said, asbestos workers who do not smoke face a fivefold increased risk for lung cancer, contrasted with a tenfold increased risk for males who smoke but who are not exposed to asbestos. For asbestos workers who smoke, the report said, the risk is more than 50 times greater and increases to 90 times greater if the worker smokes more than a pack of cigarettes a day.

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“The elimination of occupationally related chronic lung disease and cancer from the workplace should not, and frequently cannot, proceed without a companion effort to alter smoking behavior in workers,” Koop said.

Labor Groups Angry

These findings were immediately attacked by labor groups, who accused the surgeon general of minimizing the dangers of occupational hazards.

“(The report) suggests that if workers stop smoking, they will eliminate the risk of occupational disease,” a statement issued by the AFL-CIO said. “In fact, the way to eliminate occupational disease is by reducing workplace hazards.”

The AFL-CIO added: “This report can only hurt workers by undermining efforts to control workplace hazards. It will lead to misdiagnosis of occupational disease. It will make it even more difficult for workers suffering job-related disease to secure compensation to which they are entitled. And those responsible for poisoning workers will use this report to avoid legal liability.”

But Matt Myers, staff director of the Coalition on Smoking or Health, called the report a “clear-cut and important statement about what can be done to improve the health of workers” and said it is not insensitive to dangers posed by occupational hazards. “All Dr. Koop is saying is that smoking makes a bad situation worse--he is not trying to minimize the already bad situation.”

Tobacco Institute Opposition

Scott Stapf of the Tobacco Institute labeled the report “a political rather than a scientific document” and suggested it was “intended to shift the focus from workplace hazards to life styles, thus raising questions about the obligations of employers to maintain clean workplaces.”

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Koop, saying that cigarette smoking results in 340,000 premature deaths every year, said that the Tobacco Institute’s continued insistence that “the jury was still out” on smoking is the result of “their lack of belief in science.” He added: “Not a single smoker should be given assurance that the case against smoking is still in doubt. It is not.”

The report also said that smoking rates among blue-collar workers were 40% higher than among white-collar workers and that “blue-collar workers have not been as successful in giving up cigarettes as their white-collar counterparts.”

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