Smoking cessation at the workplace. Results of a randomised controlled intervention study

Abstract

Objectives-To compare the eVects of a worksite intervention by the occupational physician oVering simple advice of smoking cessation with a more active strategy of advice including a "quit date" and extra support. Population-Employees of an electrical and gas company seen at the annual visit by their occupational physicians. Criteria end points-Smoking point prevalence defined as the percentage of smokers who were non-smokers at one year. Secondary criteria were the percentage of smokers who stopped smoking for more than six months and the diVerence in prevalence of smoking in both groups. Methods-Randomised controlled trial. The unit of randomisation was the work site physician and a random sample of the employees of whom he or she was in charge. The length of the follow up was one year. Each of 30 work site physicians included in the study 100 to 150 employees. Results-Among 504 subjects classified as smokers at baseline receiving simple advice (group A) and 591 the more active programme (group B), 68 (13.5%) in group A and 109 (18.4%) were nonsmokers one year later (p=0.03; p=0.01 taking the occupational physician as the statistical unit and using a nonparametric test). Twenty three subjects (4.6%) in group A and 36 (6.1%) in group B (p=0.26) declared abstinence of six months or more. Among non-smokers at baseline, 3.4% in both groups were smokers after one year follow up. The prevalence of smokers did not diVer significantly at baseline (32.9% and 32.4%, p=0.75). After the intervention the prevalence of smoking was 30.8% in group A and 28.7% in group B (p=0.19). An increase of the mean symptoms score for depression in those who quit was observed during this period. Despite the major impact of smoking, responsible for a significant proportion of several leading causes of mortality, such as cardiovascular diseases, lung cancer and chronic bronchitis, 1 the priority of smoking cessation has not yet ranked as high in medical activities as one might expect. Asking patients whether they smoke and advising them to quit is not common practice among physicians 2 despite the evidence of eYcacy of this practice.3-7 For example, less than 50% of smokers stated that their physicians had ever advised them to stop or reduce smoking.2 5 Physicians' practices have only slightly changed in recent years with respect to tobacco counselling. 8 More attention has been paid to the pharmacological help to nicotine dependent smokers than to the potential benefits of simple advice by health personal given to a large number of smokers who may quit or consider quitting after such a simple advice. Indeed, the great majority of smokers report they have quitted without any formal programme to help them. 9 Even if the success rates that can be expected by these mass strategies are much lower than those obtained among volunteers, the large numbers of potential quitters makes the mass strategy interesting from the population and public health point of view.In France, among the worksite physician responsibilities is an annual mandator...

Smoking habits of factory workers and their thoughts about cessation of smoking

“…Sigarayı bırakmada istekli olan ve pişmanlık duygusu yaşayan içicilerin profesyonel desteğe yönlendiril-meleri önemli bir kazanç olacaktır. Yapılan çalışma-larda da iş yeri hekimi tarafından verilen bireysel danışmanlıkların ve terapiler sayesinde sigarayı bı-rakan işçilerin oranında artış olduğu gösterilmiştir [25,26].…”

Health promotion trials at worksites and risk factors for cancer

“…Four studies stratified worksites in the design phase before the randomization (11,13,36,37). Most of the trials used worksite, or whatever unit of cluster randomization, as the unit of analysis (8,11,13,22,26,27,39). Those using workers as the unit of analysis took into account the effect of the cluster randomization procedure by incorporating a nested design structure (29,36,37,51) or by using other procedures (18,30,31,35,47).…”

“…Most (N=27) of them focused on tobacco control either exclusively (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) or as part of a wider health promotion program (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Sixteen health promotion programs focused exclusively (35)(36)(37)(38)(39)(40)(41)(42)(43) or in part (23-27, 31, 34, 43) on diet.…”

“…Methods for recruitment and the intensity of the recruitment process differed among the studies and included, for example, annual medical examination (8,14), letters or phone calls (12,13,15,17,22,38,39), and recruitment through group leaders or union representatives (11,29,50). Interventions can be classified according to delivering modalities.…”

Impacto de la sintomatología depresiva en los resultados de un programa de deshabituación tabáquica en el lugar de trabajo

“…Según la información disponible, éste es el primer estudio que evalúa el impacto de la sintomatología depresiva y los antecedentes de TDM en la abstinencia tabáquica, en el contexto de una intervención laboral. Hasta ahora, los estudios que han investigado posibles variables predictoras de abstinencia tabáquica en contextos laborales, no han evaluado la depresión 27,28 o no han analizado su impacto en la abstinencia 29 . Los meta-análisis realizados sobre la eficacia de las intervenciones laborales tampoco refieren la depresión como una variable moduladora 2,30 .…”