Abstract
Objectives
In this study, the association between three levels of workplace smoking restrictions and smoking behavior and variables related to the intention to quit among continuing smokers was examined.
Methods
Adult smokers were recruited from consecutive patients attending a random sample of 34 general medical practices from a pre-defined, north-eastern German region. Self-reported data were gathered in the waiting room by questionnaire. Cross-sectional data of 1,012 employees were analyzed using ordered logistic regression analyses.
Results
Among the sample, 12% reported a smoke-free workplace, 51% had partial, and 37% no smoking restrictions. Daily cigarette consumption was lower when there were higher levels of restriction. No association was found between smoking restrictions and previous attempts to quit, nicotine dependence, or indicators of adjusted inhalation to compensate for the lower number of cigarettes (e.g. puffs per cigarette, darker coloring of filter). Smoking restrictions were positively associated with single psychological measures related to the intention to quit.
Conclusion
Employees who continue to smoke may benefit from workplace smoking restrictions in terms of reduced, active smoke exposure and psychological effects increasing their readiness to quit.
Zusammenfassung
Zielstellung
In der vorliegenden Studie wird der Zusammenhang zwischen drei Ausprägungsgraden von Rauchbeschränkungen am Arbeitsplatz und dem Rauchverhalten, sowie der Intention zur Beendigung des Tabakrauchens untersucht.
Methode
Erwachsene Raucher wurden aus einer Stichprobe von konsekutive Patienten in 34 zufällig ausgewählten hausärztlichen Praxen einer nordostdeutschen Region rekrutiert. Die Datenerhebung erfolgte per Fragebogen im Wartezimmer. Mittels ordinaler logistischer Regression wurden Daten von 1012 Berufstätigen analysiert.
Ergebnisse
In der vorliegenden Stichprobe gaben 12% an, an einem rauchfreien Arbeitsplatz beschäftigt zu sein. Keine oder partielle Rauchbeschränkungen am Arbeitsplatz berichteten 37% bzw. 51%. Ein höherer Grad der Rauchbeschränkung ging mit niedrigerem täglichem Zigarettenkonsum einher. Zwischen Rauchbeschränkungen und früheren Abstinenzversuchen, Nikotinabhängigkeit oder Indikatoren für ein kompensatorisches Inhalationsverhalten bei reduziertem Zigarettenkonsum (z.B. Züge pro Zigarette, dunklere Verfärbung des Zigarettenfilters) fand sich kein statistisch bedeutsamer Zusammenhang. Für einzelne psychologische Variablen, die nach Vorbefunden mit der Bereitschaft zur Aufgabe des Rauchens in Zusammenhang stehen, fanden sich positive Zusammenhänge mit dem Grad der Rauchbeschränkungen am Arbeitsplatz.
Schlussfolgerungen
Auch weiterhin rauchende Arbeitnehmer profitieren von Rauchbeschränkungen am Arbeitsplatz durch eine verminderte aktive Tabakrauchexposition und psychologische Effekte, welche die Bereitschaft zu Aufgabe des Rauchens erhöhen.
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References
Bauer JE, Hyland A, Li Q, Steger C, Cummings KM (2005) A longitudinal assessment of the impact of smoke-free worksite policies on tobacco use. Am J Public Health 95:1024–1029
Bergmann E, Kamtsiuris P (1999) Inanspruchnahme medizinischer Leistungen (Utilization of medical services). Gesundheitswesen 61 Spec No: S138-44
Biener L, Abrams DB, Follick MJ, Dean L (1989) A comparative evaluation of a restrictive smoking policy in a general hospital. Am J Public Health 79:192–195
Borland R, Owen N, Hocking B (1991) Changes in smoking behaviour after a total workplace smoking ban. Aust J Public Health 15:130–134
Brant R (1990) Assessing proportionality in the proportional odds model for ordinal logistic regression. Biometrics 46:1171–1178
Chapman S, Haddad S, Sindhusake D (1997) Do work-place smoking bans cause smokers to smoke “harder”? Results from a naturalistic observational study. Addiction 92:607–610
DiClemente CC, Prochaska JO, Fairhurst SK, Velicer WF, Velasquez MM, Rossi JS (1991) The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consult Clin Psychol 59:295–304
Etter JF, Perneger TV (2001) Measurement of self-reported active exposure to cigarette smoke. J Epidemiol Community Health 55:674–680
Etter JF, Bergman MM, Perneger TV (2000) On quitting smoking: development of two scales measuring the use of self-change strategies in current and former smokers (SCS-CS and SCS-FS). Addict Behav 25:523–538
Fichtenberg CM, Glantz SA (2002) Effect of smoke-free workplaces on smoking behavior: systematic review. Br Med J 325:188–191
Friedrich V, Brügger A, Bauer G (2009) Worksite tobacco prevention in the canton of Zurich: stages of change, predictors, and outcome. Int J Public Health 54:427–438
Halpern MT, Taylor H (2009) Bieliefs regarding smoking in workplaces. Results from the global workplace smoking survey. Int J Public Health 54:403–408
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO (1991) The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict 86:1119–1127
Heloma A, Jaakkola MS (2003) Four-year follow-up of smoke exposure, attitudes and smoking behavior following enactment of Finland’s national smoke-free work-place law. Addiction 98:1111–1117
Herzog TA, Blagg CO (2007) Are most precontemplators contemplating smoking cessation? Assessing the validity of the stages of change. Health Psychol 26:222–231
Hopkins DP, Briss PA, Ricard CJ, Husten CG, Carande-Kulis VG, Sharp DJ, Harris JR, Woollery TA, Harris KW, TTFoCP Services (2001) Reviews of evidence regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke. Am J Prev Med 20:16–66
Hughes JR (2000) Reduced smoking: an introduction and review of the evidence. Addiction 95(suppl 1):S3–S7
Hughes JR, Keely JP, Fagerstrom KO, Callas PW (2005) Intentions to quit smoking change over short periods of time. Addict Behav 30:653–662
Jäkle C, Keller S, Baum E, Basler H-D (1999) Skalen zur Selbstwirksamkeit und Entscheidungsbalance im Prozeß der Verhaltensänderung von Rauchern (Scales for the measurement of self-efficacy and decisional balance in the process of behavioral change in smokers). Diagnostica 45:138–146
Kelbsch J, Meyer C, Rumpf HJ, John U, Hapke U (2005) Stages of change and other factors in ‘light’ cigarette smokers. Eur J Public Health 15:146–151
Lall R, Campbell MJ, Walters SJ, Morgan K (2002) A review of ordinal regression models applied on health-related quality of life assessments. Stat Methods Med Res 11:49–67
Lee JM, Chenz SH, Hsieh CJ (2008) Does perceived safety of light cigarettes encourage smokers to smoke more or to inhale more deeply? Int J Public Health 53:236–244
Levy DT, Friend KB (2003) The effects of clean indoor air laws: what do we know and what do we need to know? Health Educ Res 18:592–609
Littell JH, Girvin H (2002) Stages of change. A critique. Behav Modif 26:223–273
Localio AR, Berlin JA, Ten Have TR, Kimmel SE (2001) Adjustment for center in multicenter studies: an overview. Ann Intern Med 135:112–123
Long JS, Freese J (2006) Regression models for categorical dependent variables using Stata, 2nd edn. Stata Press, Texas
Meyer C, Ulbricht S, Baumeister SE, Schumann A, Ruge J, Bischof G, Rumpf HJ, John U (2008) Proactive interventions for smoking cessation in general medical practice: a quasi-randomized controlled trial to examine the efficacy of computer-tailored letters and physician-delivered brief advice. Addiction 103:294–304
Miller WR, Rollnick S (2002) Motivational interviewing. Preparing people for change. The Guilford Press, New York
Miller WR, Benefield RG, Tonigan JS (1993) Enhancing motivation for change in problem drinking: a controlled comparison of two therapist styles. J Consult Clin Psychol 61:455–461
Moyers TB, Rollnick S (2002) A motivational interviewing perspective on resistance in psychotherapy. J Clin Psychol 58:185–193
Thyrian JR, John U (2006) Measuring activities in tobacco control across the EU. The MAToC. Subst Abuse Treat Prev Policy 1:9
Tönjes B, Meyer C, Ulbricht S, Schumann A, Rüge J, Rumpf HJ, John U (2007) Skalen zur Erfassung der Konstrukte des Transtheoretischen Modells zur Änderung des Rauchverhaltens. Psychometrische Eigenschaften in einer Stichprobe hausärztlicher Patienten (Scales to assess constructs of the transtheoretical model regarding change in smoking behavior: psychometric properties in a sample of general practice patients). Z Gesundheitspsychol 15:67–77
US Department of Health and Human Services (1986) The Health Consequences of Involuntary Smoking. A Report of the Surgeon-General. US Department of Health and Human Services, Centers for Disease Control, Washington, DC
Velicer WF, Prochaska JO, Fava JL, Rossi JS, Redding CA, Laforge RG, Robbins ML (2000) Using the transtheoretical model for population-based approaches to health promotion and disease prevention. Homeostasis 40:174–195
Wakefield MA, Wilson D, Owen L, Esterman A, Roberts L (1992) Workplace smoking restrictions, occupational status, and reduced cigarette consumption. J Occup Environ Med 34:693–697
West R (2005) Time for a change: putting the transtheoretical (stages of change) model to rest. Addiction 100:1036–1039
Williams R (2006) Generalized ordered logit/partial proportional odds models for ordinal dependent variables. Stata J 6:58–62
Woodruff TJ, Rosbrook B, Pierce J, Glantz SA (1993) Lower levels of cigarette consumption found in smoke-free workplaces in California. Arch Intern Med 153:1485–1493
Acknowledgments
This study is part of the Research Collaboration in Early Substance Use Intervention (EARLINT), funded by the German Federal Ministry of Education and Research (grant no. 01EB0120, 01EB0420), the Social Ministry of the State of Mecklenburg-West Pomerania (grant no. IX311a 406.68.43.05), the German Research Foundation (Deutsche Forschungsgemeinschaft, grant no. JO150/6-1) and the Krupp von Bohlen and Halbach foundation.
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Rüge, J., Broda, A., Ulbricht, S. et al. Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers. Int J Public Health 55, 599–608 (2010). https://doi.org/10.1007/s00038-009-0111-1
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DOI: https://doi.org/10.1007/s00038-009-0111-1