WORK ENVIRONMENT AND SOCIAL STATUS AS PREDICTORS OF SMOKING CESSATION – A FIVE-YEAR FOLLOW-UP STUDY Karen Albertsen, Vilhelm Borg, Harald Hannerz, Herman Burr National Institute of Occupational health Denmark

Work environment as predictor of smoking cessation  Data from the Danish National Work environment Cohort Study  1990, 1995 and 2000  3606 observations of smokers  606 quitters after five years

Hypothesis: The likelihood of cessation will be increased by:  Moderate psychological demands at work  High decision latitude and skill discretion  Social support, if there are few colleagues who smoke The likelihood of cessation will be decreased by:  Social support, if there are many colleagues who smoke  Noise, cold, chemical and physical load

Factors included:  Gender, age, base year, social status  Psychosocial work environment: Decision latitude (control), job insecurity, skills discretion (possibilities for development), social support, conflicts at work, workload, responsibility, concentration.  Other work environmental factors: passive smoking, noise, cold, chemical exposures, physical load, working hour

VariablesLevelOR without SESOR with SES Age18-29 years years years 50<= years Base year Heavy smokingNo Yes NoiseLow Medium High Physical loadLow Medium High ResponsibilityLow Medium High Psychological demands Low Medium High

The probability of cessation decreases:  If you are a heavy smoker (> 15)  If you are exposed to noise  If you are exposed to high physical work load

The probability of cessation increases:  With time  If you are either young or old  If you have high psychological demands at work  If you have moderate or high responsibility at work

Hypothesis 1: The likelihood of cessation will be increased by moderate psychological demands at work  Partly supported  against the hypothesis high psychological demands were more predictive than moderate  To be busy might reduce the urge for cigarettes  Boring work might make it difficult to maintain a quitting attempt

Hypothesis 2: The likelihood of cessation will be increased by high decision latitude and skill discretion  Not exactly supported  Moderate and high levels of responsibility at work were predictive of cessation.  The moderate level most  A moderate level of responsibility at work might be a resource while a high level might be a burden.

Hypothesis 3+4 The likelihood of cessation will be increased by social support, if there are few colleagues who smoke and decreased, if there are many colleagues who smoke  Not substantiated in our study  Shortcomings in the study:  The measuring of the concept needs to be more specific  The proxy measure of smoking colleagues (ETS) not satisfactory

Hypothesis 5:The likelihood of cessation will be decreased by noise, cold, chemical and physical load  Supported with regard to physical load and noise, not with regard to chemical exposures and cold  Physically demanding work might trigger a need for frequent and short rest periods.  Smoking might justify a break and act as a direct physical stimulant  Sporadic exposure to noise is more annoying than constant noise, which might require hearing protection.

Perspectives for practice  Because the work environment influences the lifestyle  Because it can increase the motivation to participate in health promotion programs  Integration of health promotion and changes in the work environment

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