The Economic Fruits of Smokefree Schools

May 7, 2007 — -- It has become almost too cliché to repeat: Smoking is hazardous to your health.

All of us know the litany of diseases associated with smoking: cancer, heart attacks, emphysema. This list barely scratches the surface, since smoking affects every organ system.

Many people also recognize the hazards of secondhand smoking, most of which mirror those of smoking.

But did you know that smoking is hazardous to the financial health of our nation's school systems?

Winston-Salem/Forsyth County School Board, in Winston-Salem, N.C., votes May 22 on whether this school system will go tobacco free, campuswide.

No smoking in the parking lots, in the football stadiums, at school events.

This system educates about 51,000 children, making it the fifth-largest school district in North Carolina and the 94th largest in the nation. There are 40 elementary schools, 15 middle schools and 11 high schools.

A City Built on Smoke

To put it mildly, this is an astounding place for a school board to consider a vote on smokefree schools, campuswide.

Tobacco money virtually built this town, which lent its name to Winston and Salem cigarettes. RJ Reynolds Tobacco Company is headquartered here, and generations of local residents have worked in the tobacco-related industry or agriculture in some form.

The town even acquired the sobriquet Camel City, after the popular brand of cigarettes. To paraphrase a common bumper sticker seen around North Carolina: Tobacco money pays our bills.

Even our school bills.

Amazing or not, though, it is imperative that the financial hazards of tobacco use be factored in to considerations of smokefree schools by school board members and taxpayers here and across the nation. This is because smoking-related costs to any school system are staggering. And that applies to school systems well-beyond tobacco land.

The Financial Side of Smoking

In the United States, the Centers for Disease Control and Prevention estimates that one smoker loses 33 hours per year to illness -- not even counting loss of productivity.

Let's take Winston-Salem/Forsyth County Schools as an example and see how this figure works itself out in one school system's costs.

About 21 percent of American adults smoke. Given that the local schools employ approximately 7,500 adults, this translates into about 1,575 smokers.

Do the math, and the result is 51,975 hours in lost work time due tobacco-related absenteeism in our school system. Even if you cut this number by 17 percent to account for many teachers and administrators working 10 months per year, the result is 43,139 hours in sick days.

Smoking breaks during school pile on additional lost hours. A faculty or staff member who takes a 10-minute smoking break twice a day over 40 weeks racks up 60 hours per year of time spent smoking and not doing his or her job.

Again, averaging that over the estimated 1,575 smokers employed by the school system, this yields 94,500 hours spent smoking.

Someone is covering those lost hours either in the form of substitute teachers, which is an added cost to the school since faculty and staff get paid sick days, or in the form of colleagues covering for smokers while they are on smoking breaks, which reduces overall productivity and, according to studies, can generate resentment by the nonsmoker who does not take that time off or who covers for the smoker.

Summing all tobacco-related lost time yields 137,639 hours up in smoke in Camel City.

More pertinent to the bottom line is the estimated excess cost smoking employees accrue to the school system. The CDC places this number at approximately $1,300 per smoker, which, applied to Winston-Salem/Forsyth County Schools, yields about $2.1 million additional costs.

Calculating this number a different way, based on a median income of $40,000 for the typical school employee, hourly losses total $2.8 million, which is in the same ballpark.

Unfortunately, the financial situation might be worse than these estimates suggest, since they do not include ever-increasing health insurance costs associated with tobacco use.

Smoke-Free Schools Help

Campuswide smokefree schools in any school system increases faculty and staff smoking cessation rates, which will help reduce these costs.

In addition, students in schools that go smokefree are 40 percent less likely to begin to smoke, and obviously see fewer adults who smoke serving as role models.

Teachers are especially powerful role models. Studies have shown that students who see their teachers smoke are more likely to discount the health risks associated with smoking. Purely from a health standpoint for our students, completely smokefree schools make sense.

Despite the above analyses, critics of smokfree schools remain. The major faction of critics is the smokers' rights groups, bound together by the belief that an adult should be able to choose whether he or she smokes.

The biggest problem with this argument is that it ignores the secondhand smoke exposure suffered by nonsmokers -- including children -- a health treatise unto itself. Nor does this argument address the absenteeism and productivity costs outlined above.

Furthermore, smokers' rights is a ruse. Consider this example: One cannot imagine that a school employee anywhere in the country would be able to drink a glass of wine with lunch, even though one daily glass of wine is healthy and is unlikely to cause inebriation -- even if the drinker argued "wine drinkers' rights."

In fact, one could reason that a glass-of-wine-a-day drinking policy for teachers should be legalized -- and tobacco banned -- because wine is healthy and because there is no secondhand exposure to toxins by bystanders.

Of Puffs and Politics

In Winston-Salem, though, it gets a bit trickier. Our school board has political concerns to take into account as it votes for or against tobacco-free schools. That is because RJ Reynolds, headquartered in our town, has contributed mightily over the years to the prosperity and vitality of Winston-Salem.

We live in a wonderful community. Nonetheless, show these bottom line numbers to any business manager at RJ Reynolds worth her salt, and she would be in denial to argue against them, and incompetent to ignore them.

It will be interesting to see how the Winston-Salem/Forsyth County School Board votes later this month. If it is savvy, it will vote for a measure that not only will improve the health of faculty, staff and children but also improve the financial health of the school district.

Ladies and gentlemen of the nation's school boards: There are free dollars out there, and they are as easy to grasp as low-hanging fruit.

Carpe Diem.

Dr. John Spangler is director of tobacco-intervention programs and a professor of family medicine at Wake Forest University School of Medicine.