1. Yale-Griffin Prevention Research Center
Tailored Interventions for Smoking Cessation: Experience in the worksite
Meghan O’Connell, MPH
Yale-Griffin Prevention Research Center

2. Presentation Outline Purpose Background Overview of Methods Results
Conclusions

3. Purpose To replicate the promising results of a
pilot study using an approach to
smoking cessation termed “impediment
profiling” in the worksite setting

4. Background
Cigarette smoking is the leading cause of preventable death in the U.S.1
The CDC’s Community Guide to Preventive Services recommends smoking cessation interventions be made available2
Worksites as an important venue3
Potential benefits to both employees and employers3
Novel “Impediment Profiling” methods applied in a community hospital setting

5. Methods
PLANNING
Community hospital/PRC partnership for planning and implementation
-administration, human resources, outpatient psychiatry, dietary, volunteer services depts.
Promotion of program for manager/supervisor buy-in
Hospital/PRC resource sharing

6. Methods (cont’d) RECRUITMENT
All smoking employees were invited to participate via internal , flyers, informational sessions for each department, information provided with employee benefits package, letters sent to all employees

7. Methods (cont’d.) IMPLEMENTATION
Use of Impediment Profiling (IP) instrument (previously validated) for barrier identification
Assignment to interventions as indicated by measurement scales:
NRT; treatment for anxiety/depression; dietary
counseling and PA for weight gain prevention;
stress reduction; family support groups;
referral to treatment of chemical co-
dependencies

8. Methods (cont’d.) Specific intervention components were…
Self-reported quit status was verified with measurement of carbon monoxide (CO) concentration in expired air
Smoking cessation was defined as CO reading of < 10ppm.

9. Results
55 enrolled
4 dropped out prior to study commencement, resulting in sample of 51 employees
88% of participants had previously attempted to quit
Stages of Change survey indicated subjects were in the following stages at baseline: 8% precontemplative
69% contemplative
23% action

10. Subjects

11. Percentage of subjects with impediments:

12. Participation

15. Conclusions
This study achieved a 39% one-year quit rate, replicating pilot findings indicating that IP and tailoring of interventions results in a dramatic improvement over quit rates reported in the literature
Seventy-seven percent of participants were in either the precontemplative or contemplative “stage of change” at enrollment, suggesting that providing individualized assistance may be highly effective at increasing/maintaining motivation to quit

16. Conclusions (cont’d)
Independent of quit rate, profiling impediments to smoking cessation served to identify otherwise ignored health problems meriting treatment in their own right
Further study of impediment profiling as a smoking cessation adjunct in larger, longer, and randomized trials is warranted

17. Conclusions (cont’d)
The study demonstrated the feasibility of applying IP methods in a worksite setting
Hospitals in particular are ideal settings for smoking cessation interventions. By capitalizing on existing resources and involving stakeholders, creative programs can be implemented to benefit the entire workforce

18. Yale-Griffin Prevention Research Center
David L. Katz, MD, MPH, FACPM Project PI
Beth Comerford, MS Co-investigator
Meghan O’Connell, MPH Research Associate
Hilary Alonso Data Analyst
Michelle LaRovera Research Assistant
For more information:

19. References
Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs-August Atlanta GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, August 1999.
Wasserman, M.P Guide to Community Preventive Services: State and local opportunities for tobacco use reduction. American Journal of Preventive Medicine: 20 (S2) pp 8-9.
3. Centers for Disease Control and Prevention. Making Your workplace Smoke-free: A decision makers guide. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Wellness Councils of America and American Cancer Society.