The effectiveness of workplace smoking cessation programmes: a meta-analysis of recent studies

Abstract

Objective: Using meta-analytic procedures, we compare the effectiveness of recent controlled trials of worksite smoking cessation during the 1990s with a previous meta-analysis of programmes conducted in the 1980s. Data sources: ABI/Inform, BRS, CHID, Dissertation Abstracts International, ERIC, Medline, Occupational Health and Safety Database, PsycInfo, Smoking and Health Database, SSCI, and Sociological Abstracts. Study selection: Controlled smoking cessation interventions at the workplace with at least six months follow up published from 1989 to 2001 and reporting quit rates (QRs). Data extraction: Two reviewers independently scanned titles/abstracts of relevant reports, and we reached consensus regarding inclusion/exclusion of the full text reports by negotiation. A third reviewer resolved disagreements. Two reviewers extracted data according to a coding manual. Consensus was again reached through negotiation and the use of a third reviewer. Data synthesis: 19 journal articles were found reporting studies conforming to the study's inclusion criteria. Interventions included self help manuals, physician advice, health education, cessation groups, incentives, and competitions. A total of 4960 control subjects were compared with 4618 intervention subjects. The adjusted random effects odds ratio was 2.03 (95% confidence interval 1.42 to 2.90) at six months follow up, 1.56 (95% CI 1.17 to 2.07) at 12 months, and 1.33 (95% CI 0.95 to 1.87) at more than 12 months follow up. Funnel plots were consistent with strong publication bias at the first two follow ups but not the third. In Fisher et al's 1990 study, the corresponding ORs were 1.18, 1.66, and 1.18. Conclusions: Smoking cessation interventions at the worksite showed initial effectiveness, but the effect seemed to decrease over time and was not present beyond 12 months. Compared to the Fisher (1990) analysis, the effectiveness was higher for the six month follow up. Disappointingly, we found methodological inadequacies and insufficient reporting of key variables that were similar to those found in the earlier meta-analysis. This prevented us from determining much about the most effective components of interventions. It is advisable for researchers conducting studies in the future to report data on attrition and retention rates of participants who quit, because these variables can affect QRs.

An integrated Approach to Worksite Tobacco Use Prevention and Oral Cancer Screening Among Factory Workers in Mumbai, india

“…Workplaces (employers) incur a significant cost with employees consuming tobacco at work, besides the direct impact on health of the employee. Also worksites have the potential to provide sustained peer group support and positive peer influence for quitting and staying tobacco free with the convenience of cessation opportunities and programmes on-site for the employee (Smedslund et al, 2004). The tobacco cessation efforts are compounded in a multiple ways in Indian settings where the smokeless forms of tobacco usage abound in diverse forms in multicultural urban settings, with a much wider spectrum of tobacco and health problems.…”

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

“…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 . Además, la presente investigación tiene una elevada validez externa, puesto que se trata de una muestra amplia de trabajadores con distintas ocupaciones, que acuden voluntariamente, sin ser seleccionados por criterios de dependencia o de patología psiquiátrica y a los que no se asigna ningún tratamiento determinado.…”

Randomised controlled trials for policy interventions: a review of reviews and meta-regression

“…Eight reviews are included in this section: Cambach et al, 98 Davis and Gidycz, 90 Griffith et al, 100 Jacobs et al, 92 Mullen et al, 93 Oliver et al, 103 Smedslund et al, 104 and Wilson et al 96 (see Table 6, Appendices 4.5-4.7).…”

“…91,92,94,99,[101][102][103][104] Four of these reviews stated a priori that they would investigate potential moderators of effect. 91,95,96,104 The alternative approach was to pool all studies in a meta-analysis, and then investigate potential moderators of effect (an aspect of the study that varies from one study to the next) including randomisation on the average estimate of effect. This approach was taken in the remaining eight reviews, and usually involved a large number of studies that varied enormously in terms of intervention, population, outcomes and outcome measures.…”

“…[98][99][100][101][102][103][104][105] None of the included reviews assessed the effects of legislation and only one (the hospital falls prevention programme review) 103 included interventions aimed at modifying the environment. In terms of the scope of the intervention, the majority aimed to make changes within institutional settings, such as hospitals, schools or the workplace.…”