A systematic review of the impact of work environment on smoking cessation, relapse and amount smoked

Background. Smoking is an important issue for the majority of the worldʹs working population. It is important to explore in which ways the workplace might contribute to changes in smoking status and smoking behavior. The present article provides a systematic review and quality assessment of studies that have addressed the impact of factors in the work environment on smoking behavior. Methods. An evaluation of the methodological quality of 22 prospective studies was based on 14 explicit criteria, which included features of study design, statistical analysis, sampling issues and measurement. The level of scientific evidence was evaluated for each study. Results. There was strong evidence for an effect of the work environment on the amount smoked, but insufficient or mixed evidence regarding cessation and relapse. Summarizing the results, high job demands were associated with higher amount smoked and with increased likelihood of cessation. Resources at work and social support were positively associated with cessation and negatively associated with relapse and the amount smoked. Conclusions. The results supported the overall hypothesis that the work environment influences aspects of smoking behavior. Recommendations are made for more intervention studies where changes in work environment are carried out in combination with health promotion interventions.