The feasibility of a proactive stepped care model for worksite smoking cessation

Worksite smoking cessation interventions have achieved some success, but until recently have only intervened on those smokers at a stage of readiness to volunteer to participate in cessation programs. The present study assesses whether a sustained, proactive smoking cessation program based on a stepped care model that targets all smoking employees in the worksite can actually be delivered. In one worksite in Seattle (N = 273), a worksite-wide survey with a 99.3% response rate identified 53 smokers; subsequent new-hires added an additional 14 smokers to the worksite. This study delivered increasingly intensive intervention to those smoking employees who failed to quit smoking during the study period of 1.5 years. Telephone contacts (every 3 months) provided motivational messages tailored to the smokers' stage of cessation. Subsequent more intensive steps included self-help manuals and referrals to formal programs. The intervention also used community organization strategies, such as employee guided worksite activities to complement the individual and stepped strategies. In the study period, 18% of the smokers quit smoking. Participation rates in activities were good and on average worksite smokers moved over one stage of change from baseline toward quitting smoking.