Workplace Interventions for Smoking Cessation

A Cochrane review (abstract [Abstract], review [Abstract]) included 57 studies (61 interventions). 31 studies of workplace interventions aimed at individual workers, covering group therapy, individual counselling, self-help materials, nicotine replacement therapy and social support. Group programmes (odds ratio (OR) for cessation 1.71, 95% CI 1.05 to 2.80; 8 trials, n=1309), individual counselling (OR 1.96, 95% CI 1.51 to 2.54; 8 trials, n=3516) and pharmacotherapies (OR 1.98, 95% CI 1.26 to 3.11; 5 trials, n=1092) increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective. There was a lack of evidence that comprehensive programmes applied to the workplace as a whole reduced the prevalence of smoking. Incentive schemes increased attempts to stop smoking, though there was less evidence that they increased the rate of actual quitting.

A cluster-randomised controlled trial 2 assessed smoking cessation group training programmes in the Netherlands. 31 companies (319 smokers) were randomly assigned to the intervention group and 30 companies (285 smokers) to the control group. The control group received a weekly 90-min session of smoking cessation group training for 7 weeks at the workplace; in addition to the group training, the intervention group received vouchers for being abstinent (€50 at the end of the training programme, €50 3 months after completion of the programme, €50 after 6 months, and €200 after 12 months). 12 months after finishing the smoking cessation programme, carbon monoxide-validated abstaining from smoking in the intervention group was significantly higher than that in the control group (131 [41%] of 319 vs 75 [26%] of 284; adjusted odds ratio 1.93, 95% CI 1.31 to 2.85, p=0.0009; adjusted for education level, income level, and Fagerström score).

A study 3 analyzed which factors were associated with quit success in the above mentioned trial. Social support from colleagues was positively associated with 12-month quit success (OR 1.85, 95% CI 1.14 to 3.00, p = 0.013) while having a higher proportion of smokers in the social environment was negatively associated (OR 0.81, 95% CI 0.71 to 0.92, p = 0.002). Support from a partner was positively associated with short-term quit success (OR 2.01, 95% CI 1.23 to 3.30, p = 0.006).

References

• Cahill K, Lancaster T. Workplace interventions for smoking cessation. Cochrane Database Syst Rev 2014;(2):CD003440. [PubMed]
• van den Brand FA, Nagelhout GE, Winkens B et al. Effect of a workplace-based group training programme combined with financial incentives on smoking cessation: a cluster-randomised controlled trial. Lancet Public Health 2018;3(11):e536-e544. [PubMed]
• van den Brand FA, Nagtzaam P, Nagelhout GE et al. The Association of Peer Smoking Behavior and Social Support with Quit Success in Employees Who Participated in a Smoking Cessation Intervention at the Workplace. Int J Environ Res Public Health 2019;16(16). [PubMed]