How to increase participation in workplace smoking cessation programs

When implemented in the workplace, smoking cessation programs often struggle to recruit participants. A Dutch study looked at the barriers and drivers of this participation.

Smoking cessation programs deployed in workplaces have proven their effectiveness[1]They allow a large part of the population to be reached, including people who are far removed from the healthcare system, such as employees with the lowest incomes and little education. However, these programs suffer from low participation rates.

Noting that most workplace smoking cessation programs primarily address the needs of employers, Dutch researchers conducted a qualitative study to explore employees' expectations and barriers to ensuring greater participation.[2]. 19 semi-directed interviews on this theme were conducted between January and June 2019 with employees from various sectors of activity, in companies with more than 100 employees. A majority of the participants had already benefited from a small group smoking cessation assistance program offered by the employer.

Obstacles related to information and incentives to participate

Several obstacles to the success of smoking cessation programs in the workplace have been identified. Information on these programs is thus much less well integrated when it is only disseminated by collective email or placed on the company intranet. Staff working at night or hired on short-term contracts participate less in these programs, as do those whose work schedule has peaks that are incompatible with the proposed hours. Those not working on the company site are also less inclined to participate, these situations having multiplied with the rise of teleworking. Finally, staff who speak the language of the country poorly are more often left out of these programs.

Among the other identified obstacles, moral judgment is a major pitfall, whether it comes from the employer or colleagues, particularly in the event of failure to quit smoking. Expressing skepticism about a smoker's ability to quit also weakens the smoking cessation process. Non-smokers may feel resentment towards smokers if the quit program is perceived as an advantage for the latter, but colleagues' support for the quit process can strengthen, or even arouse, the intention to quit smoking.

Ways to increase participation in these programs at work

Five recommendations were made to improve participation in these workplace smoking cessation programs:

• Use more proactive communication strategies than a simple email. Playing on several communication media, especially word-of-mouth, attracts more attention to the program. For people who have difficulty understanding French, publishing a document in another language can be useful.
• Train local managers to address this topic and encourage requests for participation. Other respected figures in the company can also be mobilized.
• Explain to all employees why this program is being implemented and the benefits that all staff can expect from it.
• Make this program as accessible as possible, particularly by providing it in the workplace and during working hours. Adaptations, in the form of individual support, can be offered to teams experiencing difficulties accessing the program (peak hours of activity, night work). Regularly renewing these stoppage programs also increases the opportunities and chances of participation.
• Integrate the smoking cessation assistance program into a more general framework of health promotion, for example around physical activity or diet, from which all staff can benefit. Smokers participating in the smoking cessation program will benefit from this more global framework to consolidate their motivation. The obstacles encountered by these other health programs are also similar to those of smoking cessation assistance.

These recommendations would be particularly suited to better integration of the most modest and least educated employees, who also constitute the largest number of smokers. The limitations of this qualitative study, however, are that it only collected the opinions of participants over 30 years old and from structures with more than 100 employees.

Keywords: smoking cessation, professional environment, health promotion.

M.F.

[1] Fishwick D, Carroll C, McGregor M, et al. Smoking cessation in the workplace. Occup Med (London). 2013;63(8):526-536. doi:10.1093/occmed/kqt107

[2] Poole NL, Nagelhout GE, Magnée T, et al. A qualitative study assessing how reach and participation can be improved in workplace smoking cessation programs. Tobacco Prevention & Cessation. 2023;9(March):7. doi:10.18332/tpc/161589.