Predictors of Success for Smoking Cessation at the Workplace: A Longitudinal Study

Abstract

Background: The effectiveness of worksite interventions to reduce smoking is debatable. Objectives: Acomprehensive smoking cessation intervention was implemented in a community of more than 17,000 employees at three different health care companies. The primary endpoint was abstinence at 24 months (self-reported and confirmed by exhaled carbon monoxide ≤6 parts per million). Predictors of long-term abstinence were analysed by multivariable regression analysis. Methods: The study was designed as an investigator-initiated and investigator-driven, open, multicentre, cohort study; 887 smokerswere enrolled in the programme. The intervention included intensive individual counselling as well as nicotine replacement and/or bupropion according to individual preferences. Re-interventions for relapse were offered during the 24-month follow-up. Results: The abstinence rate was 37% at 24 months and did not differ among the various medication groups (p > 0.05 for all). Predictors of successful cessation were higher age (odds ratio, OR 1.47, 95% confidence interval, CI 1.08-2.00, p < 0.01), breathlessness on exertion (OR 2.26, 95% CI 1.1-4.9, p = 0.03), and a higher educational level (OR 1.81, 95% CI 1.06-3.09, p = 0.03). Higher Fagerström (OR 0.76, 95% CI 0.59-0.97, p < 0.01) and craving scores (OR 0.75, 95% CI 0.63-0.89, p < 0.01), chronic sputum production (OR 0.52, 95% CI 0.31-0.87, p = 0.01) and use of antidepressants (OR 0.54, 95% CI 0.32-0.91, p = 0.02) were associated with ongoing smoking. Conclusion: Acomprehensive smoking cessation intervention at the workplace achieves high, stable, long-term abstinence rates. Elderly, well-educated employees with breathlessness on exertion have higher odds of quitting smoking. In contrast, those with high physical dependency and more intense craving, and those reporting use of antidepressant medication or sputum production have poorer chances to quit.

Factors associated with cessation of smoking among Swiss adults between 1991 and 2011: results from the SAPALDIA cohort

“…The coexistence of smoking and depression has been extensively investigated, mainly because depression is the psychiatric disorder most associated with tobacco use [35]. Similar to our results, the aforementioned intervention study in Basel showed that smokers with a history of depression or current use of antidepressants were less likely to quit [34]. This may be related to common genetic mechanisms behind smoking initiation, nicotine dependence and depressive disorders [36,37].…”

“…A negative association between smoking cessation and chronic sputum production was also found in a recent smoking cessation intervention study conducted among 887 smoking employees in the city of Basel [34]. The coexistence of smoking and depression has been extensively investigated, mainly because depression is the psychiatric disorder most associated with tobacco use [35].…”

Unaided Smoking Cessation in Healthy Employees

“…Given the prevalence of smoking and the associated health consequences of continued smoking, it is critical to provide effective cessation interventions. Therefore, succeeding lifelong abstinence is an essential goal from the health perspective [16, 17]. …”

Biomarkers of Response to Smoking Cessation Pharmacotherapies: Progress to Date

“…Smoking-related factors associated with positive cessation outcomes include lower baseline craving [1, 2], severity of nicotine dependence [3-8], and number of cigarettes smoked per day [9-14]. Demographic variables shown to be helpful include higher educational level [15-18], older age [19, 20], and being married [21]. Studies have shown mixed results regarding gender as a determinant of successful cessation [9, 12, 20-24].…”