Healthcare provider smoking cessation advice among US worker groups

Sylvester Comprehensive Cancer, University of Miami, Miller School of Medicine, PO Box 016069 (R-669), Miami, FL 33143, USA.
Tobacco control (Impact Factor: 5.93). 11/2007; 16(5):325-8. DOI: 10.1136/tc.2006.019117
Source: PubMed


Among workers in dusty occupations, tobacco use is particularly detrimental to health because of the potential synergistic effects of occupational exposures (for example, asbestos) in causing disease. This study explored the prevalence of smoking and the reported smoking cessation discussion with a primary healthcare provider (HCP) among a representative sample of currently employed US worker groups.
Pooled data from the 1997-2003 National Health Interview Survey (NHIS) were used to estimate occupation specific smoking rates (n = 135,412). The 2000 NHIS Cancer Control Module was used to determine (among employed smokers with HCP visits) the prevalence of being advised to quit smoking by occupation (n = 3454).
The average annual prevalence of current smoking was 25% in all workers. In 2000, 84% of smokers reported visiting an HCP during the past 12 months; 53% reported being advised by their physician to quit smoking (range 42%-66% among 30 occupations). However, an estimated 10.5 million smokers were not advised to quit smoking by their HCP. Workers with potentially increased occupational exposure to dusty work environments (including asbestos, silica, particulates, etc), at high risk for occupational lung disease and with high smoking prevalence, had relatively low reported discussions with an HCP about smoking cessation, including farm workers (30% overall smoking prevalence; 42% told to quit), construction and extractive trades (39%; 46%), and machine operators/tenderers (34%; 44%).
The relatively low reported prevalence of HCP initiated smoking cessation discussion, particularly among currently employed workers with potentially synergistic occupational exposures and high current smoking prevalence, needs to be addressed through educational campaigns targeting physicians and other HCPs.

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    • "Since most Operating Engineers are men, unlike women, they may not seek regular health care. Yet even when seen by a health care provider, only 53% of construction workers were advised to quit smoking [9]. Given the high rates of smoking, the interaction between smoking and respirable dust exposure which enhances cancer rates, and lack of access to cessation interventions, an efficacious worksite smoking cessation intervention has the potential to substantially impact the health of Operating Engineers by reducing cancer rates. "
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    ABSTRACT: Recent research indicates that 35 percent of blue-collar workers in the US currently smoke while only 20 percent of white-collar workers smoke. Over the last year, we have been working with heavy equipment operators, specifically the Local 324 Training Center of the International Union of Operating Engineers, to study the epidemiology of smoking, which is 29% compared to 21% among the general population. For the current study funded by the National Cancer Institute (1R21CA152247-01A1), we have developed the Tobacco Tactics website which will be compared to the state supported 1-800-QUIT-NOW telephone line. Outcome evaluation will compare those randomized to the Tobacco Tactics web-based intervention to those randomized to the 1-800-QUIT-NOW control condition on: a) 30-day and 6-month quit rates; b) cotinine levels; c) cigarettes smoked/day; d) number of quit attempts; and e) nicotine addiction. Process evaluation will compare the two groups on the: a) contacts with intervention; b) medications used; c) helpfulness of the nurse/coach; and d) willingness to recommend the intervention to others. This will be a randomized controlled trial (N = 184). Both interventions will be offered during regularly scheduled safety training at Local 324 Training Center of the International Union of Operating Engineers and both will include optional provision of over-the-counter nicotine replacement therapy and the same number of telephone contacts. However, the Tobacco Tactics website has graphics tailored to Operating Engineers, tailored cessation feedback from the website, and follow up nurse counseling offered by multimedia options including phone and/or email, and/or e-community. Primary Analysis of Aim 1 will be conducted by using logistic regression to compare smoking habits (e.g., quit rates) of those in the intervention arm to those in the control arm. Primary analyses for Aim 2 will compare process measures (e.g., medications used) between the two groups by linear, logistic, and Poisson regression. Dissemination of an efficacious work-site, web-based smoking cessation intervention has the potential to substantially impact cancer rates among this population. Based on the outcome of this smaller study, wider scale testing in conjunction with the International Environment Technology Testing Center which services Operating Engineers across North America (including US, Mexico, and Canada) will be conducted. NCT01124110.
    BMC Public Health 05/2012; 12(1):335. DOI:10.1186/1471-2458-12-335 · 2.26 Impact Factor
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    • ") , and in dusty environments , a synergistic effect has been noted with respect to occupational lung disease ( Lee et al . , 2007 ) ."
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    ABSTRACT: A trend in consolidating livestock and poultry operations into concentrated animal feeding operations (CAFOs) potentially increases farm worker exposure to the hazards associated with high animal density conditions. The two main contributors of documented injury (fatal and non-fatal) are related to accidents with machinery and animals. Tractor rollovers are the leading accident in the area of farming machinery issues; kicks, bites, and workers being pinned between animals and fixed objects are non-machinery issues typically caused by inadequate precautions taken in the vicinity of livestock. These types of accidents are well documented; however, recommended safety strategies continue to be studied to reduce the risks and numbers of injuries associated with both machines and animals. Unlike accidents involving machinery and animals, air emission exposure and potential health effects from CAFOs are not well documented. CAFOs have the potential to show higher gaseous and particulate matter emissions compared to smaller farms. Pollutants like hydrogen sulfide, ammonia, volatile organic compounds, particulate matter, and endotoxin are emitted on CAFOs and can potentially affect worker health. These specific air emissions, their sources, and some of their harmful capabilities have been identified, and regulations have been implemented to create improved work environments on CAFOs. Despite such precautions, farm workers continue to report respiratory health symptoms related to their work environment. Air pollutant exposure and its health effects on farm workers require focused research to arrive at improved safety strategies that include mitigation techniques and protective gear to minimize adverse effects of working in CAFOs.
    Journal of agricultural safety and health 04/2008; 14(2):163-87. DOI:10.13031/2013.24349

  • Journal of the National Cancer Institute 07/2008; 100(12):830-1. DOI:10.1093/jnci/djn179 · 12.58 Impact Factor
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