pmc logo imageJournal ListSearchpmc logo image
Logo of oenvmedJournal URL: redirect3.cgi?&&auth=0HWD0hxZe-eHcYRCqSx5zR7VapMfa-utUJUVv3k6K&reftype=publisher&artid=1740534&article-id=1740534&iid=139867&issue-id=139867&jid=172&journal-id=172&FROM=Article|Banner&TO=Publisher|Other|N%2FA&rendering-type=normal&&http://oem.bmj.com/
Occup Environ Med. 2003 May; 60(5): 358–363.
doi: 10.1136/oem.60.5.358.
PMCID: PMC1740534
One year effectiveness of an individualised smoking cessation intervention at the workplace: a randomised controlled trial
F Rodriguez-Artalej..., U Lafuente, P Guallar-Castillon, D. Garteizaurrekoa, M Sainz, A Diez, A Foj, and J Banegas
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Spain. Email: fernando.artalejo/at/uam.es
Abstract
Aims: To assess the effectiveness of a smoking cessation intervention at the workplace. The intervention was adapted to smokers‘ tobacco dependence, and included minimal structured counselling at the first visit (5–8 minutes), nicotine patches for three months, and three sessions of counselling for reinforcement of abstinence (2–3 minutes) over a three month period.

Methods: Open randomised trial with two groups: the intervention group, and the control group which was subjected to standard clinical practice, consisting of short (30 seconds to one minute) sporadic sessions of unstructured medical antismoking advice. The trial was carried out among 217 smokers of both sexes, aged 20–63 years, motivated to quit smoking and without contraindications for nicotine patches, who were employees at a public transport company and at two worksites of an electric company. The main outcome measure was self reported tobacco abstinence confirmed by carbon monoxide in expired air ≤10 ppm. Analysis was performed according to intention-to-treat.

Results: The rate of continuous abstinence at 12 months was 20.2% for the intervention versus 8.7% for the control group (OR: 2.58; 95% CI: 1.13 to 5.90; p = 0.025). In subgroup analyses, effectiveness of the intervention did not vary substantially with age, tobacco dependence, number of cigarettes smoked per day, number of years of tobacco consumption, degree of desire to quit smoking, time spent with smokers, subjective health, and presence of tobacco related symptoms. Weight gain at 12 months was similar for both groups (1.69 kg in the intervention v 2.01 kg in the control group; p = 0.21).

Conclusions: A simple and easily generalisable intervention at the workplace is effective to achieve long term smoking cessation. In a setting similar to ours, nine subjects would have to be treated for three months for one to achieve continuous abstinence for 12 months.

Full Text
The Full Text of this article is available as a PDF (210K).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
  • Banegas Banegas, JR; Díez Gañán, L; Rodríguez-Artalejo, F; González Enríquez, J; Graciani Pérez-Regadera, A; Villar Alvarez, F. Mortalidad atribuible al tabaquismo en España en 1998. Med Clin (Barc). 2001 Dec 1;117(18):692–694. [PubMed]
  • Jha, P; Chaloupka, FJ. The economics of global tobacco control. BMJ. 2000 Aug 5;321(7257):358–361. [PubMed]
  • Lancaster, T; Stead, L; Silagy, C; Sowden, A. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ. 2000 Aug 5;321(7257):355–358. [PubMed]
  • Glasgow, RE; Cummings, KM; Hyland, A. Relationship of worksite smoking policy to changes in employee tobacco use: findings from COMMIT. Community Intervention Trial for Smoking Cessation. Tob Control. 1997;6(Suppl 2):S44–S48. [PubMed]
  • Farkas, AJ; Gilpin, EA; Distefan, JM; Pierce, JP. The effects of household and workplace smoking restrictions on quitting behaviours. Tob Control. 1999 8(3):261–265.Autumn; [PubMed]
  • Bonfill, X; Serra, C; López, V. Employee and public responses to simulated violations of no-smoking regulations in Spain. Am J Public Health. 1997 Jun;87(6):1035–1037. [PubMed]
  • de la Fuente, JA; Font, C; Gosalbes, V; Ballestín, M. Programa de ayuda al fumador para la atención primaria. Evaluación preliminar. Aten Primaria. 1991 May;8(5):396–400. [PubMed]
  • Maiques Galán, A; Morales Suárez-Varela, MM; Albert Doménech, G; Martínez Correcher, F; Gil Romero, J; Pascual López, L. Evaluación del programa de actividades preventivas. "Exitos" obtenidos sobre pacientes fumadores, bebedores excesivos y obesos. Aten Primaria. 1993 Nov 30;12(9):591-2–594-6. [PubMed]
  • Agustí, A; Estopá, R; González, J; Guerra, D; Marín, D; Roig, P; Salvador, T; Sánchez, L; Sobradillo, V; Bartlett, A, et al. Estudio multicéntrico de la deshabituación tabáquica con chicle de nicotina en personal sanitario. Med Clin (Barc). 1991 Oct 26;97(14):526–530. [PubMed]
  • Jiménez Ruiz, CA; Barruero Ferrero, M; Carrión Valero, F; Cordovilla, R; Hernández, I; Martínez Moragón, E; Perelló Bosch, O; Ruiz Pardo, MJ. Intervención mínima personalizada en el tratamiento del tabaquismo. Resultados de un estudio multicéntrico. Grupo de Trabajo de Tratamiento del Area de Tabaquismo. Sociedad Española de Neumología y Cirugía Torácica (SEPAR). Arch Bronconeumol. 1998 Oct;34(9):433–436. [PubMed]
  • Córdoba García, R; Martín Moros, JM; Aznar Tejero, P; Die Martínez, S; Sanz Andrés, MC; Forés Catalá, MD. Efecto de la oferta de seguimiento versus consejo aislado en una muestra de fumadores disonantes. Evaluación de la influencia del hábito tabáquico de los profesionales en esta intervención. Aten Primaria. 1990 May;7(5):350–354. [PubMed]
  • Salvador Llivina, T; Marín Tuyá, D; González Quintana, J; Iniesta Torres, C; Marsal Aranega, S; Muriana Sáez, C; Castellví Barrera, E; Agustí Vidal, A. Tratamiento del tabaquismo: comparación entre una terapia de soporte y una terapia utilizando soporte, chicle de nicotina y refuerzo del comportamiento. Med Clin (Barc). 1986 Oct 4;87(10):403–406. [PubMed]
  • Salvador Llivina, T; Marín Tuyà, D; González Quintana, J; Iniesta Torres, C; Castellví Barrera, E; Muriana Sáez, C; Agustí Vidal, A. Tratamiento del tabaquismo: eficacia de la utilización del chicle de nicotina. Estudio a doble ciego. Med Clin (Barc). 1988 Apr 23;90(16):646–650. [PubMed]
  • Martínez González, MA; Sánchez Izquierdo, F; Bueno Cavanillas, A; Delgado Rodríguez, M; Gálvez Vargas, R. Cambios en la presión arterial y en el hábito tabáquico tras 3 años de intervención multifactorial. Med Clin (Barc). 1995 Jul 8;105(6):205–210. [PubMed]
  • Aleixandre i Martí, E; Casanova Matutano, MA; Mitjans Lafont, J; Sánchez Monfort, J; Sanmartín Almenar, A. Ensayo clínico de dos intervenciones de deshabituación tabáquica en atención primaria. Aten Primaria. 1998 Oct 31;22(7):424–428. [PubMed]
  • Grandes, G; Cortada, JM; Arrazola, A. An evidence-based programme for smoking cessation: effectiveness in routine general practice. Br J Gen Pract. 2000 Oct;50(459):803–807. [PubMed]
  • Martín Cantera, C; Córdoba García, R; Jane Julio, C; Nebot Adell, M; Galán Herrera, S; Aliaga, M; Pujol Ribera, E; Ballestín, M. Evaluación a medio plazo de un programa de ayuda a los fumadores. Med Clin (Barc). 1997 Nov 29;109(19):744–748. [PubMed]
  • Toral, J; Ortega, F; Cejudo, P; Güalberto, MR; Sánchez, H; Montemayor, T. Eficacia de un programa de deshabituación al tabaco con tratamiento sustitutivo combinado de nicotina (parches más chicles) a los 6 meses de seguimiento. Arch Bronconeumol. 1998 Jun;34(6):281–284. [PubMed]
  • Nebot-Adell, M; Soler-Vila, M; Martín-Cantera, C; Birulés-Pons, M; Oller-Colom, M; Sala-Carbonell, E; Cabezas-Peña, C. Efectividad del consejo médico para dejar de fumar: evaluación del impacto al año de la intervención. Rev Clin Esp. 1989 Mar;184(4):201–205. [PubMed]
  • Nebot, M; Cabezas, C; Oller, M; Moreno, F; Rodrigo, J; Sardà, T; Mestres, J; Pitarch, M. Consejo médico, consejo de enfermería y chicle de nicotina para dejar de fumar en atención primaria. Med Clin (Barc). 1990 Jun 9;95(2):57–61. [PubMed]
  • Martín Cantera, C; Jane Julio, C; Nebot Adell, M. Evaluación anual de un programa de ayuda al fumador. Aten Primaria. 1993 Jun 30;12(2):86–90. [PubMed]
  • Costa, B; Boqué, N; Olesti, M; Benaiges, D; Arteaga, R; Carrascosa, R; Jové, J; Pérez, C; Alamo, C. Evaluación multicéntrica de un programa de diabetes en la atención primaria de Tarragona. Aten Primaria. 1991 Jan;8(1):22–24,26-8. [PubMed]
  • Sánchez Beiza, L; Martín-Carrillo Domínguez, P; Gil Serrano, P; Gómez Gil, E; Pascual de la Torre, M; Valero Martínez, A. Estudio preliminar del abandono del tabaco a los 6 meses tras consejo médico, folleto y seguimiento. Aten Primaria. 1992 Sep 15;10(4):738–741. [PubMed]
  • Quílez García, C; Hernando Arizaleta, L; Rubio Díaz, A; Granero Fernández, EJ; Vila Coll, MA; Estruch Riba, J. Estudio doble ciego de la eficacia del chicle de nicotina en la deshabituación tabáquica, dentro del ámbito de la atención primaria. Aten Primaria. 1989 Dec;6(10):719–726. [PubMed]
  • Comas Fuentes, A; Suárez Gutiérrez, R; López González, ML; Cueto Espinar, A. Efectividad a largo plazo del consejo antitabaco en atención primaria: el proceso de recaída. Rev Esp Salud Publica. 1996 70(3):283–293.May–Jun; [PubMed]
  • Moreno Ortigosa, A; Ochoa Gómez, FJ; Ramalle-Gómara, E; Saralegui Reta, I; Fernández Esteban, MV; Quintana Díaz, M. Eficacia de una intervención para dejar de fumar en pacientes con infarto de miocardio. Med Clin (Barc). 2000 Feb 19;114(6):209–210. [PubMed]
  • Eriksen, MP; Gottlieb, NH. A review of the health impact of smoking control at the workplace. Am J Health Promot. 1998 13(2):83–104.Nov–Dec; [PubMed]
  • Willemsen, MC; de Vries, H; van Breukelen, G; Genders, R. Long-term effectiveness of two Dutch work site smoking cessation programs. Health Educ Behav. 1998 Aug;25(4):418–435. [PubMed]
  • Lang, T; Nicaud, V; Slama, K; Hirsch, A; Imbernon, E; Goldberg, M; Calvel, L; Desobry, P; Favre-Trosson, JP; Lhopital, C; Mathevon, P; Miara, D; Miliani, A; Panthier, F; Pons, G; Roitg, C; Thoores, M. Smoking cessation at the workplace. Results of a randomised controlled intervention study. Worksite physicians from the AIREL group. J Epidemiol Community Health. 2000 May;54(5):349–354. [PubMed]
  • Richmond, RL; Kehoe, LA; Webster, IW. Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. Addiction. 1993 Aug;88(8):1127–1135. [PubMed]
  • Manley, M; Epps, RP; Husten, C; Glynn, T; Shopland, D. Clinical interventions in tobacco control. A National Cancer Institute training program for physicians. JAMA. 1991 Dec 11;266(22):3172–3173. [PubMed]
  • Heatherton, TF; Kozlowski, LT; Frecker, RC; Fagerström, KO. The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991 Sep;86(9):1119–1127. [PubMed]
  • Hughes, JR; Hatsukami, D. Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry. 1986 Mar;43(3):289–294. [PubMed]
  • Russell, MA; Stapleton, JA; Feyerabend, C; Wiseman, SM; Gustavsson, G; Sawe, U; Connor, P. Targeting heavy smokers in general practice: randomised controlled trial of transdermal nicotine patches. BMJ. 1993 May 15;306(6888):1308–1312. [PubMed]
  • Tønnesen, P; Nørregaard, J; Simonsen, K; Säwe, U. A double-blind trial of a 16-hour transdermal nicotine patch in smoking cessation. N Engl J Med. 1991 Aug 1;325(5):311–315. [PubMed]
  • Jorenby, DE; Hatsukami, DK; Smith, SS; Fiore, MC; Allen, S; Jensen, J; Baker, TB. Characterization of tobacco withdrawal symptoms: transdermal nicotine reduces hunger and weight gain. Psychopharmacology (Berl). 1996 Nov;128(2):130–138. [PubMed]
  • Dale, LC; Schroeder, DR; Wolter, TD; Croghan, IT; Hurt, RD; Offord, KP. Weight change after smoking cessation using variable doses of transdermal nicotine replacement. J Gen Intern Med. 1998 Jan;13(1):9–15. [PubMed]