Health Promotion Strategies to Reduce Tobacco Use among Blue-Collar Workers

1
Health Promotion Strategies to Reduce Tobacco Use
among Blue-Collar Workers

• Deborah McLellan, Elizabeth Harden, Glorian
  Sorensen
• 2002 National Conference on Tobacco or Health
• San Francisco, California
• November 19, 2002

2
Learner Outcomes

• Describe at least two components of a tobacco use
  reduction model for blue-collar workers.
• Describe a process for designing a tobacco use
  reduction intervention using qualitative research
  findings.
• Apply these strategies for blue-collar workers in
  your community.

3
Topics to be Covered

• Occupational class disparities in smoking
  prevalence, cessation, and exposure.
• WellWorks a worksite-based tobacco use reduction
  program with blue-collar workers.
• Recommendations to reduce tobacco use with
  blue-collar workers.

4
Smoking Prevalence Rates by Occupational Class
U.S. Data
Giovino, 2000
5
What else do we know about blue-collar workers?

• As compared to white collar workers, blue-collar
  workers have
• lower rates of quitting smoking
• higher exposure rates to secondhand smoke
• Less access to programs and lower participation
• Current programs and policies have not been as
  successful with blue-collar workers

6
WellWorks Integrating Health Promotion and
Occupational Health

• The background listening to blue-collar workers
  talk about smoking and other health priorities
• Synergistic effects of dual exposures
• Address blue-collar workers social context by
  integrating health promotion with occupational
  health
• Social ecological theory points to importance of
  conducting multilevel interventions
• Participatory strategies

7
WellWorksResearch Question

• Does an intervention integrating health promotion
  with occupational health and safety result in
  increases in smoking cessation compared to a
  standard health promotion intervention?

8
WellWorks Study Design
9
WellWorksResults

• Blue-collar workers were twice as likely to quit
  smoking in the HP/OHS condition (12 vs. 6)
• There was no gender effect, so appears equally
  successful among women and men.

10
Examples of the WellWorks multilevel
intervention integrating HP and OHS

• Participatory strategies
• Organizational
• Interpersonal
• Individual

11
WellWorks Participatory Strategies

• Employee Advisory Boards

12
WellWorksOrganizational Level Intervention

• Labor-management approach
• Policies
• Uniformly enforce worksite nonsmoking policies
• Financial coverage for cessation treatment
• In HP/OHS condition reduce occupational health
  risks
• CO exposure

13
WellWorksInterpersonal Level Intervention

• Promoting social support and social norms
  supportive of worker health
• Group smoking cessation classes with integrated
  HP/OHS messages

14
WellWorksIndividual Interventions

• Reduce structural barriers for workers to
  participate in interventions
• Allow workers to participate on work time
• Provide interventions by stage of readiness to
  change
• Brochures, goal setting activities, trial
  behaviors
• Integrate tobacco and occupational health
  messages
• CO analyzer

15
Challenges to Delivering an Integrated
Intervention

• Common challenges to worksite interventions
• Management resistance
• Resistance from health and safety personnel
• Forging the perspectives of two disciplines

16
Recommended components to reduce tobacco use
among blue collar workers

• Let theoretical frameworks and evidenced-based
  research guide your programs
• Use participatory methods
• Address workers social context by integrating
  occupational health concerns with tobacco
  reduction strategies.
• Conduct interventions at the organizational,
  interpersonal, and individual levels