The relationship between smoking and health care, workers' compensation, and productivity costs for a large employer.

OBJECTIVE

To quantify and compare employee health- and productivity-related costs for current smokers versus nonsmokers for a large US employer.

METHODS

Multivariate regression models were used to compare medical, pharmacy, workers' compensation, and short-term disability costs, self-reported absenteeism, and presenteeism by smoking status. Costs were aggregated over 3 years, from 2008 to 2010.

RESULTS

Controlling for demographic variables, smokers had significantly different health care utilization patterns, as well as higher absenteeism and presenteeism costs. Overall, employees who smoke were estimated to cost employers $900 to $1383 more than their nonsmoking counterparts.

CONCLUSIONS

Current smokers experience incrementally greater lost productivity than nonsmokers, contributing to employer costs associated with smoking. Increased employer focus on smoking cessation may help mitigate these organizational costs.