The costs of employee smoking. A computer simulation of hospital nurses.

A computer simulation model of the economic impact of employee smoking on an employer was developed with a population of hospital nurses as the example. Net economic impact was calculated by estimating cumulative costs borne by the employer under various scenarios and comparing them with projected costs estimated from baseline data. The model included the following: baseline number of staff, baseline percentage of smokers, annual employee turnover rate, number of smokers interested in quitting, the cost of a smoking cessation program, expected success rate of a voluntary cessation program, smokers quitting spontaneously without a program, and employer-borne costs related to employee smoking. A variety of scenarios were constructed to generate a range of employer net economic impact figures and resulting percentages of smoking employees. Results showed that the benefits of a cessation program would be eliminated over several years, unless the prevalence of smoking in incoming employees was reduced. The most favorable scenario, combining a hospital cessation program and reduced smoking among new employees, generated cumulative savings, discounted at 5%, of $358,000 to $684,000 over an eight-year period.