摘要：Objectives. We investigated the relationship between implementation of workplace smoking cessation support activities and employee smoking cessation. Methods. In 2 cohort studies, participants were 6179 Finnish public-sector employees who self-reported as smokers at baseline in 2004 (study 1) or 2008 (study 2) and responded to follow-up surveys in 2008 (study 1; n = 3298; response rate = 71%) or 2010 (study 2; n = 2881; response rate = 83%). Supervisors’ reports were used to assess workplace smoking cessation support activities. We conducted multilevel logistic regression analyses to examine changes in smoking status. Results. After adjustment for sociodemographic characteristics, number of cigarettes smoked per day, work unit size, shift work, type of job contract, health status, and health behaviors, baseline smokers whose supervisors reported that the employing agency had offered pharmacological treatments or financial incentives were more likely than those in workplaces that did not offer such support to have quit smoking. In general, associations were stronger among moderate or heavy smokers (≥ 10 cigarettes/day) than among light smokers (< 10 cigarettes/day). Conclusions. Cessation activities offered by employers may encourage smokers, particularly moderate or heavy smokers, to quit smoking. Smoking bans are increasingly used to reduce smoking and exposure to secondhand smoke. Bans have been widely implemented in the European Union countries, and the Centers for Disease Control and Prevention predicts that by 2020 or sooner, all US states will have laws banning smoking in all indoor areas of private-sector work sites, restaurants, and bars. 1 Smoke-free work environments are associated with higher smoking cessation rates. 2,3 Workplaces are often the setting for efforts to promote smoking cessation. Beyond workplace smoking restrictions and campaigns to reduce smoking, employers offer various types of support for smoking cessation, including support groups, nicotine replacement therapy, other pharmacological treatments, and financial incentives. 4 A review of workplace interventions showed strong evidence that interventions directed toward individual smokers, such as individual and group counseling and pharmacological treatment, increase the likelihood of smoking cessation. 4 By contrast, there was only limited evidence that participation in cessation programs can be increased by competitions and incentives. 5 Another review showed that worksite-based multicomponent programs involving incentives and competitions in combination with other interventions can be effective. 6 Similarly, a recent study conducted at a large company revealed that financial incentives significantly increase cessation rates. 7 Self-help interventions and social support have been found to be less effective. 4 It is not clear whether the effectiveness of interventions varies according to initial smoking intensity, that is, number of cigarettes smoked per day. Hyland et al. 8 suggested that low-level smokers may have different intervention needs than heavier smokers. Most studies have been limited by small sample sizes or have been conducted in a small number of work sites, so the extent to which findings are generalizable to other populations and settings is uncertain. In a large sample of smokers from more than 1000 public-sector work units, we examined whether employer-offered smoking cessation support activities were associated with a higher likelihood of quitting smoking independently of a number of other factors, including sociodemographic characteristics, work-related factors, health status, and health behaviors. In addition, we examined whether the effects of smoking cessation support activities on smoking cessation varied according to prior smoking intensity.
