Smoking intervention in the workplace: review and recommendations

Growing interest has been expressed by the business community concerning intervention against smoking in the workplace. As most adult smokers are unlikely to have access to smokers' clinics or other treatment facilities outside the workplace, the workplace itself could be an ideal location for the provision of treatment programs. If the interest of the business community can be translated into action, large populations of smokers would become accessible to workplace treatment programs. Despite this possibility, the potential of the workplace for smoking intervention remains largely unexplored. In this review, the main reasons for workplace smoking intervention are discussed, and the available evidence for the main strategies (prohibition, incentives, treatment, and multicomponent) is reviewed and critically evaluated. The current emphasis in treatment studies is still on physician counseling, and the quality of reported work uneven. Many published studies not intended as evaluations, and many of those which are, have severe procedural or methodological flaws. The particular problems of evaluating workplace studies are discussed and the current research position is summarized. Because the number of evaluative studies is small, the recommendations that can be based on them are fairly limited. In conclusion, it is argued that a body of well-controlled evaluations is needed before the unique characteristics of the workplace can be assessed and exploited in smoking interventions.