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Smoking Control Programmes at Merrill Lynch and Company, Inc.: A Case Study

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In 1990, the US Government demonstrated strong support for workplace health promotion programs with the publication of Healthy People 2000, setting forth the National Health Promotion and Disease Prevention Objectives for the Year 2000 (US Public Health Service 1991). One of these objectives calls for an increase in the percentage of worksites offering health promotion activities for their employees by the year 2000, “preferably as part of a comprehensive employee health promotion program” (Objective 8.6). Two objectives specifically include efforts to prohibit or severely restrict smoking at work by increasing the percentage of worksites with a formal smoking policy (Objective 3.11) and by enacting comprehensive state laws on clean indoor air (Objective 3.12).

In response to these objectives and employee interest, Merrill Lynch and Company, Inc. (hereafter called Merrill Lynch) launched the Wellness and You program for employees at headquarters locations in New York City and in the state of New Jersey. Merrill Lynch is a US-based, global financial management and advisory company, with a leadership position in businesses serving individuals as well as corporate and institutional clients. Merrill Lynch’s 42,000 employees in more than 30 countries provide services including securities underwriting, trading and brokering; investment banking; trading of foreign exchange, commodities and derivatives; banking and lending; and insurance sales and underwriting services. The employee population is diverse in terms of ethnicity, nationality, educational achievement and salary level. Nearly half of the employee population is headquartered in the New York City metropolitan area (includes part of New Jersey) and in two service centers in Florida and Colorado.

Merrill Lynch’s Wellness and You Program

The Wellness and You program is based in the Health Care Services Department and is managed by a doctorate-level health educator who reports to the medical director. The core wellness staff consists of the manager and a full-time assistant, and is supplemented by staff physicians, nurses and employee assistance counselors as well as outside consultants as needed.

In 1993, its initial year, over 9,000 employees representing approximately 25% of the workforce participated in a variety of Wellness and You activities, including the following:

  • self-help and written information programmes, including the distribution of pamphlets on a diversity of health topics and a Merrill Lynch personal health guide designed to encourage employees to get the tests, immunizations, and guidance they need to stay healthy
  • educational seminars and workshops on topics of broad interest such as smoking cessation, stress management, AIDS, and Lyme disease
  • comprehensive screening programmes to identify employees at risk for cardiovascular disease, skin cancer, and breast cancer. These programmes were provided by outside contractors on company premises either in health services clinics or mobile van units
  • ongoing programmes, including aerobic exercise in the company cafeteria and personal weight management classes in company conference rooms
  • clinical care, including influenza immunizations, dermatology services, periodic health examinations and nutritional counselling in the employee health services clinics.

 

 

In 1994, the program expanded to include an onsite gynecology screening program comprising of Pap smears and pelvic and breast examinations; and a worldwide emergency medical assistance program to help American employees locate an English-speaking doctor anywhere in the world. In 1995, wellness programs will be extended to service offices in Florida and Colorado and will reach approximately half of the entire workforce. Most services are offered to employees free of charge or at nominal cost.

Smoking Control Programs at Merrill Lynch

Anti-smoking programs have gained a prominent place in the workplace wellness arena in recent years. In 1964, the US Surgeon General identified smoking as the single cause of the greater part of preventable disease and premature death (US Department of Health, Education, and Welfare 1964). Since then, research has demonstrated that the health risk from inhaling tobacco smoke is not limited to the smoker, but includes those who inhale second-hand smoke (US Department of Health and Human Services 1991). Consequently, many employers are taking steps to limit or curtail smoking by employees out of concern for employee health as well as their own “bottom lines”. At Merrill Lynch, Wellness and You includes three types of smoking cessation effort: (1) the distribution of written material, (2) smoking cessation programs, and (3) restrictive smoking policies.

Written materials

The wellness program maintains a wide selection of quality educational materials to provide information, assistance and encouragement to employees to improve their health. Self-help materials such as pamphlets and audiotapes designed to educate employees about the harmful effects of smoking and about the benefits of quitting are available in the health care clinic waiting rooms and through interoffice mail by request.

Written materials also are distributed at health fairs. Often these health fairs are sponsored in conjunction with national health initiatives so as to capitalize on existing media attention. For example, on the third Thursday of each November, the American Cancer Society sponsors the Great American Smokeout. This national campaign, designed to encourage smokers to give up cigarettes for 24 hours, is well publicized throughout the United States by television, radio and newspapers. The idea is that if smokers can prove to themselves that they can quit for the day, they might quit for good. In 1993’s Smokeout, 20.5% of smokers in the United States (9.4 million) stopped smoking or reduced the number of cigarettes they smoked for the day; 8 million of them reported continuing not to smoke or reducing their smoking one to ten days later.

Each year, members of Merrill Lynch’s medical department set up quit-smoking booths on the day of the Great American Smokeout at home office locations. Booths are stationed in high-traffic locations (lobbies and cafeterias) and provide literature, “survival kits” (containing chewing gum, cinnamon sticks, and self-help materials), and quit-smoking pledge cards to encourage smokers to quit smoking at least for the day.

Smoking cessation programs

Since no single smoking cessation program works for everyone, employees at Merrill Lynch are offered a variety of options. These include self-help written materials (“quit kits”), group programs, audiotapes, individual counseling and physician intervention. Interventions range from education and classic behavior modification to hypnosis, nicotine replacement therapy (e.g., “the patch” and nicotine chewing gum), or a combination. Most of these services are available to employees free of charge and some programs, such as group interventions, have been subsidized by the firm’s benefits department.

Non-smoking policies

In addition to smoking cessation efforts aimed at individuals, smoking restrictions are becoming increasingly common in the workplace. Many jurisdictions in the United States, including the states of New York and New Jersey, have enacted strict workplace smoking laws that, for the most part, limit smoking to private offices. Smoking in common work areas and conference rooms is permitted, but only if each and every person present agrees to allow it. The statutes typically mandate that non-smokers’ preferences receive priority even to the point of banning smoking entirely. Figure 1 summarizes the city and state regulations applicable in New York City.

Figure 1. Summary of city and state restrictions on smoking in New York.

HPP260F1

In many offices, Merrill Lynch has implemented smoking policies which extend beyond the legal requirements. Most headquarters cafeterias in New York City and in New Jersey have gone smoke-free. In addition, total smoking bans have been implemented in some office buildings in New Jersey and Florida, and in certain work areas in New York City.

There seems to be little debate about the adverse health effects of tobacco exposure. However, other issues should be considered in developing a corporate smoking policy. Figure 2 outlines many of the reasons why a company may or may not elect to restrict smoking beyond the legal requirements.

Figure 2. Reasons for and against restricting smoking in the workplace.

HPP260F2

Evaluation of Smoking Cessation Programs and Policies

Given the relative youth of the Wellness and You program, no formal evaluation has yet been conducted to determine the effect of these efforts on employee morale or smoking habits. However, some studies suggest that worksite smoking restrictions are favored by a majority of employees (Stave and Jackson 1991), result in decreased cigarette consumption (Brigham et al. 1994; Baile et al. 1991; Woodruff et al. 1993), and effectively increase smoking cessation rates (Sorensen et al. 1991).

 

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Health Protection and Promotion References

Adami, HG, JA Baron, and KJ Rothman. 1994. Ethics of a prostate cancer screening trial. Lancet (343):958-960.

Akabas, SH and M Hanson. 1991. Workplace drug and alcohol programmes in the United States. Working paper given at Proceedings of the Washington Tripartite Symposium on Drug and Alcohol Prevention and Assistance Programmes at the Workplace. Geneva: ILO.

American College of Obstetricians and Gynecologists (ACOG). 1994. Exercise during Pregnancy and the Postpartum Period. Vol. 189. Technical Bulletin. Washington, DC: DCL.

American Dietetic Association (ADA) and Office of Disease Prevention and Health Promotion. 1994. Worksite Nutrition: A Guide to Planning, Implementation, and Evaluation. Chicago: ADA.

American Lung Association. 1992. Survey of the public’s attitudes toward smoking. Prepared for the Gallup Organization by the American Lung Association.

Anderson, DR and MP O’Donnell. 1994. Toward a health promotion research agenda: “State of the Science” reviews. Am J Health Promot (8):482-495.

Anderson, JJB. 1992. The role of nutrition in the functioning of skeletal tissue. Nutr Rev (50):388-394.

Article 13-E of the New York State Public Health Law.

Baile, WF, M Gilbertini, F Ulschak, S Snow-Antle, and D Hann. 1991. Impact of a hospital smoking ban: Changes in tobacco use and employee attitudes. Addict Behav 16(6):419-426.

Bargal, D. 1993. An international perspective on the development of social work in the workplace. In Work and Well-Being, the Occupational Social Work Advantage, edited by P Kurzman and SH Akabas. Washington, DC: NASW Press.

Barr, JK, KW Johnson, and LJ Warshaw. 1992. Supporting the elderly: Workplace programs for employed caregivers. Milbank Q (70):509-533.

Barr, JK, JM Waring, and LJ Warshaw. 1991. Employees’ sources of AIDS information: The workplace as a promising educational setting. J Occup Med (33):143-147.

Barr, JK and LJ Warshaw. 1993. Stress among Working Women: Report of a National Survey. New York: New York Business Group on Health.

Beery, W, VJ Schoenbach, EH Wagner, et al. 1986. Health Risk Appraisal: Methods and Programs, with Annotated Bibliography. Rockville, Md: National Center for Health Services Research and Health Care Technology Assessment.

Bertera, RL. 1991. The effects of behavioral risks on absenteeism and healthcare costs in the workplace. J Occup Med (33):1119-1124.

Bray, GA. 1989. Classification and evaluation of the obesities. Med Clin North Am 73(1):161-192.

Brigham, J, J Gross, ML Stitzer, and LJ Felch. 1994. Effects of a restricted worksite smoking policy on employees who smoke. Am J Public Health 84(5):773-778.

Bungay, GT, MP Vessey, and CK McPherson. 1980. Study of symptoms of middle life with special reference to the menopause. Brit Med J 308(1):79.

Bureau of National Affairs (BNA). 1986. Where There’s Smoke: Problems and Policies Concerning Smoking in the Workplace. Rockville, Md: BNA.

—. 1989. Workplace smoking, corporate practices and developments. BNA’s Employee Relations Weekly 7(42): 5-38.

—. 1991. Smoking in the workplace, SHRM-BNA survey no. 55. BNA Bulletin to Management.

Burton, WN and DJ Conti. 1991. Value-managed mental health benefits. J Occup Med (33):311-313.

Burton, WN, D Erickson, and J Briones. 1991. Women’s health programs at the workplace. J Occup Med (33):349-350.

Burton, WN and DA Hoy. 1991. A computer-assisted health care cost management system. J Occup Med (33):268-271.

Burton, WN, DA Hoy, RL Bonin, and L Gladstone. 1989. Quality and cost effective management of mental health care. J Occup Med (31):363-367.

Caliber Associates. 1989. Cost-Benefit Study of the Navy’s Level III Alcohol Rehabilitation Programme Phase Two: Rehabilitation vs Replacement Costs. Fairfax, Va: Caliber Associates.

Charafin, FB. 1994. US sets standards for mammography. Brit Med J (218):181-183.

Children of Alcoholics Foundation. 1990. Children of Alcoholics in the Medical System: Hidden Problems, Hidden Costs. New York: Children of Alcoholics Foundation.

The City of New York. Title 17, chapter 5 of the Administration Code of the City of New York.

Coalition on Smoking and Health. 1992. State Legislated Actions On Tobacco Issues. Washington, DC: Coalition on Smoking and Health.

Corporate Health Policies Group. 1993. Issues of Environmental Tobacco Smoke in the Workplace. Washington, DC: National Advisory Committee of the Interagency Committee on Smoking and Health.

Cowell, JWF. 1986. Guidelines for fitness-to-work examinations. CMAJ 135 (1 November):985-987.

Daniel, WW. 1987. Workplace Industrial Relations and Technical Change. London: Policy Studies Institute.

Davis, RM. 1987. Current trends in cigarette advertising and marketing. New Engl J Med 316:725-732.

DeCresce, R, A Mazura, M Lifshitz, and J Tilson. 1989. Drug Testing in the Workplace. Chicago: ASCP Press.

DeFriese, GH and JE Fielding. 1990. Health risk appraisal in the 1990s: Opportunities, challenges, and expectations. Annual Revue of Public Health (11):401-418.

Dishman, RH. 1988. Exercise Adherence: Its Impact On Public Health. Champaign, Ill: Kinetics Books.

Duncan, MM, JK Barr, and LJ Warshaw. 1992. Employer-Sponsored Prenatal Education Programs: A Survey Conducted By the New York Business Group On Health. Montvale, NJ: Business and Health Publishers.

Elixhauser, A. 1990. The costs of smoking and the effectiveness of smoking-cessation programs. J Publ Health Policy (11):218-235.

European Foundation for the Improvement of Living and Working Conditions.1991. Overview of innovative action for workplace health in the UK. Working paper no. WP/91/03/EN.

Ewing, JA. 1984. Detecting alcoholism: The CAGE questionnaire. JAMA 252(14):1905-1907.

Fielding, JE. 1989. Frequency of health risk assessment activities at US worksites. Am J Prev Med 5:73-81.

Fielding, JE and PV Piserchia. 1989. Frequency of worksite health promotion activities. Am J Prev Med 79:16-20.

Fielding, JE, KK Knight, RZ Goetzel, and M Laouri. 1991. Utilization of preventive health services by an employed population. J Occup Med 33:985-990.

Fiorino, F. 1994. Airline outlook. Aviat week space technol (1 August):19.

Fishbeck, W. 1979. Internal Report and Letter. Midland, Michigan: Dow Chemical Company, Corporate Medical Dept.

Food and Agriculture Organization of the United Nations (FAO) and World Health Organization (WHO). 1992. International Conference on Nutrition: Major Issues for Nutrition Strategies. Geneva: WHO.

Forrest, P. 1987. Breast Cancer Screening 1987. Report to the Health Ministers of England, Wales, Scotland, and Ireland. London: HMSO.

Freis, JF, CE Koop, PP Cooper, MJ England, RF Greaves, JJ Sokolov, D Wright, and Health Project Consortium. 1993. Reducing health care costs by reducing the need and demand for health services. New Engl J Med 329:321-325.

Glanz, K and RN Mullis. 1988. Environmental interventions to promote healthy eating: A review of models, programs, and evidence. Health Educ Q 15:395-415.

Glanz, K and T Rogers. 1994. Worksite nutrition programs in health promotion in the workplace. In Health Promotion in the Workplace, edited by MP O’Donnell and J Harris. Albany, NY: Delmar.

Glied, S and S Kofman. 1995. Women and Mental Health: Issues for Health Reform. New York: The Commonwealth Fund.

Googins, B and B Davidson. 1993. The organization as client: Broadening the concept of employee assistance programs. Social Work 28:477-484.

Guidotti, TL, JWF Cowell, and GG Jamieson. 1989. Occupational Health Services: A Practical Approach. Chicago: American Medical Association.

Hammer, L. 1994. Equity and gender issues in health care provision: The 1993 World Bank Development Report and its implications for health service recipients. Working Paper Series, no.172. The Hague: Institute of Social Studies.

Harris, L et al. 1993. The Health of American Women. New York: The Commonwealth Fund.

Haselhurst, J. 1986. Mammographic screening. In Complications in the Management of Breast Disease, edited by RW Blamey. London: Balliere Tindall.

Henderson, BE, RK Ross, and MC Pike. 1991. Toward the primary prevention of cancer. Science 254:1131-1138.

Hutchison, J and A Tucker. 1984. Breast screening results from a healthy, working population. Clin Oncol 10:123-128.

Institute for Health Policy. October, 1993. Substance Abuse: The Nation’s Number One Health Problem. Princeton: Robert Wood Johnson Foundation.

Kaplan, GD and VL Brinkman-Kaplan. 1994. Worksite weight management in health promotion in the workplace. In Health Promotion in the Workplace, edited by MP O’Donnell and J Harris. Albany, NY: Delmar.

Karpilow, C. 1991. Occupational Medicine in the Industrial Workplace. Florence, Ky: Van Nostrand Reinhold.

Kohler, S and J Kamp. 1992. American Workers under Pressure: Technical Report. St. Paul, Minn.: St. Paul Fire and Marine Insurance Company.

Kristein, M. 1983. How much can business expect to profit from smoking cessation? Prevent Med 12:358-381.

Lesieur, HR and SB Blume. 1987. The South Oaks Gambling Screen (SOGS): A new instrument for the identification of pathological gamblers. Am J Psychiatr 144(9):1184-1188.

Lesieur, HR, SB Blume, and RM Zoppa. 1986. Alcoholism, drug abuse and gambling. Alcohol, Clin Exp Res 10(1):33-38.

Lesmes, G. 1993. Getting employees to say no to smoking. Bus Health (March):42-46.

Lew, EA and L Garfinkel. 1979. Variations in mortality by weight among 750,000 men and women. J Chron Dis 32:563-576.

Lewin, K. [1951] 1975. Field Theory in Social Science: Selected Theoretical Papers by Kurt
Lewin, edited by D Cartwright. Westport: Greenwood Press.

Malcolm, AI. 1971. The Pursuit of Intoxication. Toronto: ARF Books.
M
andelker, J. 1994. A wellness program or a bitter pill. Bus Health (March):36-39.

March of Dimes Birth Defects Foundation. 1992. Lessons Learned from the Babies and You Program. White Plains, NY: March of Dimes Birth Defects Foundation.

—. 1994. Healthy Babies, Healthy Business: An Employer’s Guidebook on Improving Maternal and Infant Health. White Plains, NY: March of Dimes Birth Defects Foundation.

Margolin, A, SK Avants, P Chang, and TR Kosten. 1993. Acupuncture for the treatment of cocaine dependence in methadone-maintained patients. Am J Addict 2(3):194-201.

Maskin, A, A Connelly, and EA Noonan. 1993. Environmental tobacco smoke: Implications for the workplace. Occ Saf Health Rep (2 February).

Meek, DC. 1992. The impaired physician programme of the Medical Society of the District of Columbia. Maryland Med J 41(4):321-323.

Morse, RM and DK Flavin. 1992. The definition of alcoholism. JAMA 268(8):1012-1014.

Muchnick-Baku, S and S Orrick. 1992. Working for Good Health: Health Promotion and Small Business. Washington, DC: Washington Business Group on Health.

National Advisory Council for Human Genome Research. 1994. Statement on use of DNA testing for presymptomatic identification of cancer risk. JAMA 271:785.

National Council on Compensation Insurance (NCCI). 1985. Emotional Stress in the Workplace—New Legal Rights in the Eighties. New York: NCCI.

National Institute for Occupational Safety and Health (NIOSH). 1991. Current Intelligence Bulletin 54. Bethesda, Md: NIOSH.

National Institutes of Health (NIH). 1993a. National High Blood Pressure Education Program Working Group Report on Primary Prevention of Hypertension. National High Blood Pressure Education Program, National Heart, Lung, and Blood Institute. NIH publication No. 93-2669. Bethesda, Md: NIH.

—. 1993b. Second Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP II). National Cholesterol Education Program, National Institutes of Health, National Heart, Lung, and Blood Institute. NIH publication no. 93-3095. Bethesda, Md: NIH.

National Research Council. 1989. Diet and Health: Implications for Reducing Chronic Disease Risk. Washington, DC: National Academy Press.

New York Academy of Medicine. 1989. Drugs in the workplace: Proceedings of a symposium. B NY Acad Med 65(2).

Noah, T. 1993. EPA declares passive smoke a human carcinogen. Wall Street J, 6 January.

Ornish, D, SE Brown, LW Scherwitz, JH Billings, WT Armstrong, TA Ports, SM McLanahan, RL Kirkeeide, RJ Brand, and KL Gould. 1990. Can lifestyle changes reverse coronary heart disease? The lifestyle heart trial. Lancet 336:129-133.

Parodi vs. Veterans Administration. 1982. 540 F. Suppl. 85 WD. Washington, DC.

Patnick, J. 1995. NHS Breast Screening Programmes: Review 1995. Sheffield: Clear Communications.

Pelletier, KR. 1991. A review and analysis of the cost effective outcome studies of comprehensive health promotion and disease prevention programs. Am J Health Promot 5:311-315.

—. 1993. A review and analysis of the health and cost-effective outcome studies of comprehensive health promotion and disease prevention programs. Am J Health Promot 8:50-62.

—. 1994. Getting your money’s worth: The strategic planning programme of the Stanford Corporate Health Programme. Am J Health Promot 8:323-7,376.

Penner, M and S Penner. 1990. Excess insured health costs from tobacco-using employees in a large group plan. J Occup Med 32:521-523.

Preventive Services Task Force. 1989. Guide to Clinical Preventive Services: An Assessment of the Effectiveness of 169 Interventions. Baltimore: Williams & Wilkins.

Richardson, G. 1994. A Welcome for Every Child: How France Protects Maternal and Child Health-A New Frame of Reference for the United States. Arlington, Va: National Center for Education in Maternal and Child Health.

Richmond, K. 1986. Introducing heart healthy foods in a company cafeteria. J Nutr Educ 18:S63-S65.

Robbins, LC and JH Hall. 1970. How to Practice Prospective Medicine. Indianapolis, Ind: Methodist Hospital of Indiana.

Rodale, R, ST Belden, T Dybdahl, and M Schwartz. 1989. The Promotion Index: A Report Card on the Nation’s Health. Emmaus, Penn: Rodale Press.

Ryan, AS and GA Martinez. 1989. Breastfeeding and the working mother: A profile. Pediatrics 82:524-531.

Saunders, JB, OG Aasland, A Amundsen, and M Grant. 1993. Alcohol consumption and related problems among primary health care patients: WHO collaborative project on early detection of persons with harmful alcohol consumption-I. Addiction 88:349-362.

Schneider, WJ, SC Stewart, and MA Haughey. 1989. Health promotion in a scheduled cyclical format. J Occup Med 31:482-485.

Schoenbach, VJ. 1987. Appraising health risk appraisal. Am J Public Health 77:409-411.

Seidell, JC. 1992. Regional obesity and health. Int J Obesity 16:S31-S34.

Selzer, ML. 1971. The Michigan alcoholism screening test: The quest for a new diagnostic instrument. Am J Psychiatr 127(12):89-94.

Serdula, MK, DE Williamson, RF Anda, A Levy, A Heaton and T Byers. 1994. Weight control practices in adults: Results of a multistate survey. Am J Publ Health 81:1821-24.

Shapiro, S. 1977. Evidence of screening for breast cancer from a randomised trial. Cancer:2772-2792.

Skinner, HA. 1982. The drug abuse screening test (DAST). Addict Behav 7:363-371.

Smith-Schneider, LM, MJ Sigman-Grant, and PM Kris-Etherton. 1992. Dietary fat reduction strategies. J Am Diet Assoc 92:34-38.

Sorensen, G, H Lando, and TF Pechacek. 1993. Promoting smoking cessation at the workplace. J Occup Med 35(2):121-126.

Sorensen, G, N Rigotti, A Rosen, J Pinney, and R Prible. 1991. Effects of a worksite smoking policy: Evidence for increased cessation. Am J Public Health 81(2):202-204.

Stave, GM and GW Jackson. 1991. Effect of total work-site smoking ban on employee smoking and attitudes. J Occup Med 33(8):884-890.

Thériault, G. 1994. Cancer risks associated with occupational exposure to magnetic fields among electric utility workers in Ontario and Quebec, Canada, and France. Am J Epidemiol 139(6):550-572.

Tramm, ML and LJ Warshaw. 1989. Screening for Alcohol Problems: A Guide for Hospitals, Clinics, and Other Health Care Facilities. New York: New York Business Group on Health.

US Department of Agriculture: Human Nutrition Information Service. 1990. Report of the Dietary Guidelines Advisory Committee On Dietary Guidelines for Americans. Publication no. 261-495/20/24. Hyattsville, Md: US Government Printing Office.

US Department of Health, Education and Welfare. 1964. Smoking and Health Report of the Advisory Committee to the Surgeon General of the Public Health Service. PHS Publication No. 1103. Rockville, Md: US Department of Health, Education, and Welfare.

US Department of Health and Human Services (USDHHS). 1989. Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. USDHHS publication no.10 89-8411.Washington, DC: US Government Printing Office.

—. 1990. Economic Costs of Alcohol and Drug Abuse and Mental Illness. DHHS publication no. (ADM) 90-1694. Washington, DC: Alcohol, Drug Abuse, and Mental Health Administration.

—. 1991. Environmental Tobacco Smoke in the Workplace: Lung Cancer and Other Effects. USDHHS (NIOSH) publication No. 91-108. Washington, DC: USDHHS.
US Food and Drug Administration (FDA). 1995. Mammography quality deadline. FDA Med Bull 23: 3-4.

US General Accounting Office. 1994. Long-Term Care: Support for Elder Care Could Benefit the Government Workplace and the Elderly. GAO/HEHS-94-64. Washington, DC: US General Accounting Office.

US Office of Disease Prevention and Health Promotion. 1992. 1992 National Survey of Worksite Health Promotion Activities: Summary Report. Washington, DC: Department of Health and Human Services, Public Health Service.

US Public Health Service. 1991. Healthy People 2000: National Health Promotion and Disease Prevention Objectives—Full Report With Commentary. DHHS publication No. (PHS) 91-50212. Washington, DC: US Department of Health and Human Services.

Voelker, R. 1995. Preparing patients for menopause. JAMA 273:278.

Wagner, EH, WL Beery, VJ Schoenbach, and RM Graham. 1982. An assessment of health hazard/health risk appraisal. Am J Public Health 72:347-352.

Walsh, DC, RW Hingson, DM Merrigan, SM Levenson, LA Cupples, T Heeren, GA Coffman, CA Becker, TA Barker, SK Hamilton, TG McGuire, and CA Kelly. 1991. A randomized trial of treatment options for alcohol-abusing workers. New Engl J Med 325(11):775-782.

Warshaw, LJ. 1989. Stress, Anxiety, and Depression in the Workplace: Report of the NYGBH/Gallup Survey. New York: The New York Business Group on Health.

Weisman, CS. 1995. National Survey of Women’s Health Centers: Preliminary Report for Respondents. New York: Commonwealth Fund.

Wilber, CS. 1983. The Johnson and Johnson Program. Prevent Med 12:672-681.

Woodruff, TJ, B Rosbrook, J Pierce, and SA Glantz. 1993. Lower levels of cigarette consumption found in smoke-free workplaces in California. Arch Int Med 153(12):1485-1493.

Woodside, M. 1992. Children of Alcoholics At Work: The Need to Know More. New York: Children of Alcoholics Foundation.

World Bank. 1993. World Development Report: Investing in Health. New York: 1993.

World Health Organization (WHO). 1988. Health promotion for working populations: Report of a WHO expert committee. Technical Report Series, No.765. Geneva: WHO.

—. 1992. World No-Tobacco Day Advisory Kit 1992. Geneva: WHO.

—. 1993. Women and Substance Abuse: 1993 Country Assessment Report. Document No. WHO/PSA/93.13. Geneva: WHO.

—. 1994. A Guide On Safe Food for Travellers. Geneva: WHO.

Yen, LT, DW Edington, and P Witting. 1991. Prediction of prospective medical claims and absenteeism for 1,285 hourly workers from a manufacturing company, 1992. J Occup Med 34:428-435.