A recent poll by the Lansing, Mich., research firm EPIC/MRI found smokers typically take three cigarette breaks each work day, with each break averaging 13 minutes. Applying an average pay rate of $13 an hour, that works out to $1.7 billion in lost productivity for businesses in the Great Lakes state.

"I wasn't surprised by the survey," says Gary McMullen, vice-president for public relations and communications at the Great Lakes Division of the American Cancer Society (ACS). "I think it's just more evidence that there is nothing positive about smoking."

McMullen says the poll will be used for educational purposes. "It's a tool that organizations like the American Cancer Society can use to convince state legislatures and the public at large that doing something about tobacco will not only create a healthier society, but a more productive society," he says.

The poll of 1,800 Michigan adults, which was commissioned by a consortium of 17 state hospitals, also found:

• Twenty-one percent of the state's adults are smokers. Young people smoke at a slightly higher rate, 23 percent.
• Men smokers outnumber women, 23 percent to 21 percent.
• Whites and blacks smoke at the same rate: 21 percent. The rate for Hispanics is 39 percent.
• Among current smokers, 41 percent have tried to quit and failed.
• Almost half of those who have quit the habit did so cold turkey.
• Smoking rates decline in middle age and thereafter. Among Michigan residents, 28 percent rate of those aged 30 to 40 are smokers, while only 17 percent of those in the 55 to 64 age bracket smoke. That number drops to 11 percent for those 65 and older.

Vernice Davis Anthony, vice president of community health for St. John Health System in Detroit ? one of the hospitals in the consortium ? says the survey points to the need to help people stop smoking ? or to convince them never to smoke in the first place. "I think we need to come up with strategies that are more broad-based in terms of dealing with our young people. We need to target them directly," she says.

Davis Anthony says she was surprised the poll showed 49 percent of those who quit did so cold turkey. "What it tells me is that the most important thing is to make up your mind to quit smoking. The message is that you have to keep on quitting until it sticks," she says.

Oakwood Healthcare System in Dearborn, a western suburb of Detroit, was also a part of the consortium. Amy Middleton, Oakwood's director of marketing, agreed with Davis Anthony?s sentiments. "This just validates what we already knew. We have to hit the younger population because the younger you are, the more addictive smoking is," she says.

Oakwood will make adjustments to some of their programs because of the survey, she adds. "We'll look at what we are offering the community. Sometimes the patches work, sometimes hypnosis, sometimes classes. It just points out that we all have to do whatever we can to help people stop smoking."