Workplace cessation support is associated with more abstinence in a workplace program in Hong Kong: A mixed-methods study

INTRODUCTION We examined the association of workplace smoking cessation (SC) support from employers, in addition to SC interventions, and smoking abstinence. METHODS Smoking employees ( ≥ 1 cigarette daily, aged ≥ 18 years) from companies of various industries joined a workplace SC program in Hong Kong. Self-reported past 7-day point prevalence abstinence was measured at follow-up at 6 months. We assessed 14 types of workplace SC support with higher scores (range: 0–14) indicating greater support. Multivariable logistic regression examined the prospective association between workplace SC support and smoking abstinence, adjusting for intention to quit, nicotine dependence, self-efficacy of quitting, and sociodemographic characteristics. Average marginal effects were calculated to test if the association between overall workplace SC support and self-reported past 7-day PPA at follow-up at 6 months was modified by subgroups. We also interviewed employers from different companies to explore their perspectives of providing workplace SC support, and the data were analyzed by thematic analysis. RESULTS In 383 participants who received a heath talk, a self-help SC booklet, and 15 text messages, greater workplace SC support was associated with smoking abstinence (AOR=1.32; 95% CI: 1.08–1.61), including support for smoke-free environment (AOR=1.51; 95% CI: 1.08–2.11) and for SC attempts/actions (AOR=1.93; 95% CI: 1.21–3.07). The association did not differ by sex, age, intention to quit, nicotine dependence, company size or company type. Qualitative interviews found that employers provided workplace SC support to establish a good company image, cost-benefit considerations were important to the types of workplace SC support provided, and lack of SC knowledge was a barrier to providing workplace SC support. CONCLUSIONS Greater workplace SC support was associated with more abstinence in a workplace SC program.