Blue-collar workers and smoking

July 25 2002 - Working-class people are more likely to get the message if workplace smoking cessation programs are combined with other occupational health and safety messages rather than being used on a stand-alone basis. This is the result of a study conducted in Massachusetts, USA by Dana-Farber, the Harvard School of Public Health, the University of Massachusetts, and Monash Medical School in Victoria, Australia. The study involved workers at 15 manufacturing firms in Eastern Massachusetts. A full report appears in the August issue of the journal Cancer Causes and Control

"Despite an overall drop since the 1960s in the number of people who smoke, the rate of decline hasn't been equal for all groups," says the study's lead author, Glorian Sorensen, PhD, MPH, director of Dana-Farber's Center for Community-Based Research. Figures collected in 1997 showed that 37% of male and 33% of female blue-collar workers smoked, compared to 21% of men and 20% of women in white-collar occupations. And the comparisons were similar for other healthy habits such as eating sufficient fruits and vegetables (which can reduce the risk of certain kinds of cancers).

"There's evidence that although blue-collar workers attempt to quit smoking as often as other workers do, they tend to be less successful," Sorensen says. "Also, when messages about quitting smoking and eating healthily are presented in the workplace, they often don't have as big an impact on the habits of blue-collar workers as on others."

The researchers set out to test the hypothesis that such programs might be more effective if they were incorporated into ongoing efforts to reduce employees' exposure to workplace health and safety hazards. Sorensen and her colleagues randomly split the fifteen participating companies into two groups. In the first group, health-promotion activities such as smoking cessation and healthy eating were offered on a stand-alone basis. In the second group, these activities were integrated into occupational health and safety efforts.

After two years, the researchers found that over twice as many workers quit smoking in the second group (those using an integrated smoking-cessation message) than in the first group. In fact, the cessation rate had dropped virtually to the same level as that of white-collar workers. But no significant differences were found among the different groups when it came to fruit and vegetable consumption

"To our knowledge, this is the first smoking-cessation program that has produced markedly high rates of quitting smoking among blue-collar workers when tested in the workplace," says Sorensen, also a professor of health and social behavior at Harvard School of Public Health. "It offers real encouragement that similar programs could be effective on a broad scale."

How did they explain the apparent success of the combined approach? There are several possible reasons. One is that blue-collar workers may see job-related hazards as a greater threat to their health than smoking or bad nutrition. In which case, tying stop-smoking and healthy-eating programs into occupational safety efforts could help motivate workers to take action on both fronts.

The combined approach also "conveys a sense that company management shares workers' concerns about their health and is willing to do its part to help workers lead healthier lives," Sorensen explains. "It addresses the broader priorities and concerns that workers have about their health."

But why didn't the combined approach affect eating habits? The researchers speculate that there is a weaker connection between diet and occupational health in workers' minds than that for smoking. They say that more studies are needed but suggest more programs to educate workers about how good nutrition can help them be fit for work, especially physical labour.

See also: Smoking by Nurses Creates Workplace Issues

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