Effectiveness of workplace smoking policy on smoking behavior in Asian population : a systematic review

Abstract

Introduction: Smoking has been considered as one of the leading preventable cause of lung disease, cardiovascular disease and cancer. China, has 20% of the population in the world, but consumes 30% of the world’s cigarette and has suffered 1 million deaths per year from tobacco use. The workplace is an important field for smoking control, but there are relatively few reports on the current situation of workplace smoking control with the exception of reports from North American countries.

Objectives: This project aims to investigate the effectiveness of workplace smoking control policy on smokers’ behavior in Asian population, mainly the comparison of smoke free policy, smoke restriction ban with no smoking ban, and to identify the potential factors that associated with the compliance of smoking policy.

Methods：Articles that are relevant to workplace smoking policy were searched and identified through PubMed and CNKI by using a combination of keywords. Articles that studied the effects of workplace smoking control policy on smoking behavior and the factors that associated the compliance of smoke control policy were included. All studies were conducted in the Asian countries and the outcome measures were current smoking prevalence, daily cigarette consumption, and willingness to quit smoking.

Results: Of the 541 studies identified, 11 articles were identified to be relevant and included in this systematic review. Smoking-free policy was showed to be the most effective strategy to enhance the changes in smokers’ behavior. Eight of nine studies that compared smoke free with no smoke ban gave consistent conclusion that smoking free policy could reduce the prevalence of smoking dramatically. It was associated with higher willingness to quit smoking among smokers and could reduce the smokers’ daily cigarettes consumption by 3 to 4 cigarettes per day. There was limited evidence that smoke restriction policy could reduce the prevalence of smokers. Even though smoke restriction policy could reduce daily cigarettes consumption and increased the smokers’ willingness to quit smoking, but the effect was much lower than those in the workplace with smoke free policy. In addition, occupation, such as salesmen and marketing employee, the reason of implementing the smoke control policy(e.g. ‘workplace safety’, ‘maintain good air quality’, ‘reduce ETS in non-smokers’), and lack of knowledge of hazard in cigarettes were the factors contributed to the low compliance of smoke control policy.

Conclusion: Overall, workplace smoke-free policy is the most effective way in changing smoking behavior. Workplace smoke-free should be implemented as a public health priority and accompanied with health education and smoking cessation service to assure the compliance.