Care About Employee Mental Health? This Matters Too


By Amanda Graham, Ph.D. Chief of Innovations at the Ex Program by Truth Initative

In 2020, expanding employee mental health benefits is a top priority for many employers. This makes sense, as more employers find that when they invest in mental health, everyone wins.

By connecting employees with effective mental health treatment, they get the critical help they need. Plus, when employee mental health improves, employers can benefit from lower medical costs, increased productivity, lower absenteeism, and decreased disability costs.

From stress to anxiety and depression, the list of mental health issues that employers strive to support is broad. Yet, there is one constant thread that pulls through, and that’s the complex interplay between smoking and mental health.

Did you know…

  • 1 in 3 adults with mental illness smoke compared to 1 in 5 adults without mental illness.
  • Approximately 1 in 4 U.S. adults have some form of mental illness or substance use disorder, and these adults consume almost 40% of all cigarettes smoked by adults.
  • Tobacco smoke can interact with and inhibit the effectiveness of certain medications taken by mental health patients.
  • People with mental illness die about 5 years earlier than those without these disorders, and many of these deaths are caused by smoking cigarettes.

So, if your benefits only address employee mental health but not tobacco use, your impact on employee well-being will fall short.

Impact of quitting smoking on employee mental health

When people quit smoking, it’s widely known that it can have a dramatic effect on their physical health; however, it also improves a person’s mental health, too.

Research shows when they stop using tobacco, smokers with mental health issues experience:

Decreases in anxiety, depression, and stress
Improved positive mood and quality of life
But while smoking has a clear impact on employees’ physical and mental health, health care providers often do not address smoking with patients who have mental health conditions.

This is why it’s essential that employers also offer a quit-smoking program, in addition to mental health benefits, to bridge this gap.

Industries with higher workplace stress, high smoking rates

Workplace stress can be a key influence on employee mental health, and certain industries see a higher prevalence of it. Manufacturing, retail, and food and beverage topped the list of industries, for example, in which employees felt the highest rates of work-related stress.

Key contributors to increased workplace stress include dissatisfaction over systems of recognition and reward, job insecurity, and, for those in retail and food beverage, low-wage living.

In the face of workplace stress, tobacco is often used as a coping strategy.

Not-so-coincidentally, tobacco use rates also run high in hospitality (30%), manufacturing (27%), and retail (24%). For employers in these industries, helping employees manage stress and supporting their overall mental health in tandem with encouraging their efforts to quit smoking is a must.

What our data shows on mental health and smoking

At the EX Program, we understand the connection between smoking and mental health. The internet is often the first place that tobacco users turn for help, and individuals with mental health conditions are no exception. About 40% of EX users in a recent study screened positive for anxiety or depression. And for smokers with mental health symptoms, engagement with EX improved their odds of quitting smoking by 30%.

The study referenced above illustrates that engagement with an evidence-based digital cessation program can be useful for smokers with mental health issues.

At the EX Program, for example, we provide dedicated content to help participants with mental health issues understand how quit medications may affect them and the impact of quitting tobacco on their mental health.

EX also offers peer support through specialized groups in our online community, such as this one, “Mental Health Support.” Our EX Coaches are specifically trained to engage participants regardless of the challenges they bring to the quitting journey.

Going for the double win

In 2020, employers will expand mental health benefits and look for other ways to improve employee well-being—to contain costs and because it’s the right thing to do when you care about your people.

However, to effectively address the entire spectrum of health, I encourage you to remember that benefits must provide opportunities for employees to concentrate on their mental health as well as quitting smoking—not one or the other.

To learn more, visit the Ex Program by the Truth Initative at