title: Benefits of quitting smoking on work productivity and activity impairment in the United States, the European Union and China.
abstract: BACKGROUND
  Smoking has important health and economic consequences for individuals and society. This study expands the understanding of work-related burden associated with smoking and benefit of smoking cessation across the US, European Union (EU) and China using large-scale, representative survey methodology.
  
  
  METHODS
  Data utilised the 2013 National Health and Wellness Survey in United States (US), EU5 (UK, France, Germany, Italy, and Spain) and China. Working-aged respondents 18-64 were used in the analyses (US N=58 500; EU5 N=50 417; China N=17 987) and were categorised into: current smokers, trying to quit, former smokers and never smokers. Generalised linear models controlling for demographics and health characteristics examined the relationship of smoking status with work productivity and activity impairment (WPAI-GH). The WPAI-GH measures were: absenteeism, presenteeism, overall work impairment, and activity impairment. Separately, current smokers were compared with those who quit 0-4, 5-10 and 11 or more years ago on WPAI-GH end-points.
  
  
  RESULTS
  Current smokers reported greater absenteeism in the US and China and greater presenteeism, overall work impairment, and activity impairment than former and never smokers across the three regions. Those who quit even 0-4 years ago demonstrated lower absenteeism, presenteeism, and activity impairment in China and lower presenteeism, overall work impairment, and activity impairment in the US and EU5.
  
  
  CONCLUSIONS
  Smoking was associated with significant work productivity loss in the US, EU5 and China. The results suggest that quitting benefits extend to work productivity rapidly after cessation, serving to further encourage and promote the implementation of workplace cessation programs.
authors.affiliation: Pfizer Inc, New York, NY, USA.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Baker
authors.affiliation: Kantar Health, Foster City, CA, USA.
authors.forename: Natalia M
authors.initials: NM
authors.lastname: Flores
authors.affiliation: Pfizer Inc, New York, NY, USA.
authors.forename: Kelly H
authors.initials: KH
authors.lastname: Zou
authors.affiliation: Pfizer Inc, New York, NY, USA.
authors.forename: Marianna
authors.initials: M
authors.lastname: Bruno
authors.affiliation: Pfizer Inc, New York, NY, USA.
authors.forename: Vannessa J
authors.initials: VJ
authors.lastname: Harrison
mesh_terms: D000041:Absenteeism; D000328:Adult; D002681:China; D004526:Efficiency; D005062:European Union; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069597:Presenteeism / Q000191:economics; D016540:Smoking Cessation / Q000191:economics*; D013997:Time Factors; D000073869:Tobacco Smoking / Q000191:economics* / Q000503:physiopathology; D014481:United States