1. 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

2. 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

3. 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

4. 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

5. VariablesLevelOR without SESOR with SES Age18-29 years 30-39 years 40-49 years 50<= years 1.00 0.75 0.74 1.00 0.70 0.93 Base year1990 1995 1.00 1.22 1.00 1.21 Heavy smokingNo Yes 1.00 0.40 1.00 0.40 NoiseLow Medium High 1.00 0.71 0.96 1.00 0.74 1.04 Physical loadLow Medium High 1.00 0.79 0.49 1.00 0.82 0.53 ResponsibilityLow Medium High 1.00 1.31 1.22 1.00 1.30 1.20 Psychological demands Low Medium High 1.00 1.27 1.42 1.00 1.25 1.33

6. 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

7. 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

8. 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

9. 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.

10. 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

11. 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.

12. 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

13. The end This presentation is available on: www.ami.dk/presentations