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.