Workplace interventions for smoking cessation

 

Abstract

Background

The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation.

Objectives

To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking or to reduce tobacco consumption.

Search methods

We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2008, MEDLINE (1966 - April 2008), EMBASE (1985 - Feb 2008) and PsycINFO (to March 2008). We searched abstracts from international conferences on tobacco and the bibliographies of identified studies and reviews for additional references.

Selection criteria

We selected interventions conducted in the workplace to promote smoking cessation. We included only randomized and quasi-randomized controlled trials allocating individuals, workplaces or companies to intervention or control conditions.

Data collection and analysis

Information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the study was abstracted by one author and checked by another. Because of heterogeneity in the design and content of the included studies, we did not attempt formal meta-analysis, and evaluated the studies using qualitative narrative synthesis.

Main results

We include 51 studies covering 53 interventions in this updated review. We found 37 studies of workplace interventions aimed at individual workers, covering group therapy, individual counselling, self-help materials, nicotine replacement therapy and social support. The results were consistent with those found in other settings. Group programmes, individual counselling and nicotine replacement therapy increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective. We also found 16 studies testing interventions applied to the workplace as a whole. There was a lack of evidence that comprehensive programmes 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.

Authors' conclusions

1. We found strong evidence that interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling and pharmacological treatment to overcome nicotine addiction. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.

2. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer.

3. We failed to detect an effect of comprehensive programmes in reducing the prevalence of smoking.

 

Plain language summary

Is the workplace an effective setting for people to stop smoking

Proven stop-smoking methods, like group therapy, individual counselling and nicotine replacement therapy, are equally effective when offered in the workplace. The evidence is less clear for self-help methods. Social and environmental support, competitions and incentives, and comprehensive programmes do not show a clear benefit in helping smokers to quit at work.

 

摘要

背景

工作場所的戒菸介入處置

工作場所有潛力做為到達鼓勵戒菸為目標的大型團體的環境。

目標

將工作場所戒菸介入的對照試驗分類和測定他們幫助工作人員停止吸菸或是減少菸草的使用量的程度。

搜尋策略

我們搜索了the Cochrane Tobacco Addiction Group Specialized Register in April 2008, MEDLINE (1966  April 2008), EMBASE (1985  Feb 2008) and PsycINFO (to March 2008)。我們搜索了討論戒菸的國際會議的摘要且檢查了已確定研究的參考書目和額外文獻的回顧。

選擇標準

我們將介入分成兩類:a)將目標訂為促進個案戒菸的介入b)將目標訂為針對工作場所的整體. 我們使用不同類型研究的不同標準. 對於真的幫助個體停止抽菸的介入,我們只將針對分配個案,針對工作場合或是公司的介入或是對照狀況的隨機對照試驗. 對於限制抽菸和設立於工作場合的看板的試驗,我們也納入了對照試驗做為基準線和介入後結果和中斷的時間系列研究.

資料收集與分析

和所有試驗介入方式、參與個案、結果和研究方法的特質和內容相關的資訊由一個作者摘要出來，被另一位作者檢查。因為納入研究的設計和內容的異質性，我們並無試圖做正式的統合分析，而使用性質敘述合述。

主要結論

我們收納了51個研究，包含了53個介入措施於本次更新當中。我們找到37個研究在工作場所針對幫助個案停止吸菸，包括了團體治療、個案諮詢、自助手冊、尼古丁替代療法及社會支持。結果與其他配置的方案的結果一致。團體方案、個案諮詢以及尼古丁替代療法，相較於無治療或是最小介入控制相比，可以增加戒斷率。自助手冊效果較小。我們還發現了16個研究測試將介入方式應用於工作地點當中作為一個整體介入研究。缺乏綜合方案可以減少吸菸盛行率的證據。獎勵計畫增加嘗試戒菸，然而較少關於增加他們的實際戒斷的比率的證據。

作者結論

我們發現1.強烈著證據顯示直接針對吸菸個案的介入增加了戒菸的可能性. 這些包括了健康專業者的建議,個案與團體的諮詢和克服尼古丁依賴的藥物治療. 自我幫助的介入有較差的效果. 所有這些無論是提供於工作場合或是其他地點的介入均有效果. 雖然人們得到這些介入很可能停止,實際戒菸的數量為低的.2.有限的證據顯示比賽和獎勵可以增加員工參與計畫的個案數.3.缺乏證據顯示全面的介入減少了吸菸的盛行率。

翻譯人

本摘要由彰化基督教醫院王智仁翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

當於工作場合提供如團體治療，個案諮詢和尼古丁替代治療(NRT)被證實對戒菸有效的方法，均相同效果。而對於自我幫助方法的證據仍是不明的。社會及環境支持、比賽和獎勵、和全面性計畫並未顯示對於幫助吸菸者在工作時戒菸有明確的助益。