Objective:The aim of this systematic literature analysis was to study the association between work health promotion and job well-being, work ability, absenteeism, and early retirement. This systematic review is a part of a large research project studying multiple workplace factors and interventions

Work health promotion, job well-being, and sickness absences--a systematic review and meta-analysis.

Smokefree policies to reduce tobacco use. A systematic review.

Background: The best thing to do to reduce the harms caused by smoking is to quit, but some people may not want to do this or may feel that they are unable to stop smoking completely. Cutting down the number of cigarettes smoked daily or using different tobacco products, such as chewing tobacco or low-tar cigarettes, may reduce some of the harm caused by smoking. It may also help people to stop smoking completely in the long term. On the other hand, reducing smoking or using other tobacco products may not improve health and could reduce a person's motivation to quit smoking altogether. It is important that we review the evidence to find out whether these approaches could help smokers who do not want to or cannot quit to reduce the harm caused by their smoking. We were mainly interested in whether these approaches improved the health of smokers, but also looked at smoking reduction and quitting rates. Study characteristics: We found 20 randomised controlled trials that tested ways to help people to cut down the number of cigarettes they smoked. Some of these just advised smokers to smoke less, but most also provided them with a product to help them cut down: nicotine replacement therapy (NRT), varenicline, bupropion, electronic cigarettes (ecigs), or snus (a form of smokeless, oral tobacco). We also found four randomized controlled trials that tested the effects of using cigarettes designed to reduce the damage caused by smoking: reduced tar, carbon or nicotine cigarettes. Most of the studies used NRT to help people to reduce their smoking. All of the studies included people who were not planning to quit smoking soon. The research is current to October 2015. Key results: Eight studies (with 3081 smokers) found that using NRT roughly doubled the likelihood of halving the number of cigarettes smoked each day, compared to using a placebo. Using NRT in this way also nearly doubled the likelihood of quitting completely. One trial each tested bupropion, varenicline, ecigs and snus to help reduce the harms caused by smoking, and there was no evidence that any of these treatments helped smokers to reduce the number of cigarettes they were smoking each day. This may be because there has not yet been enough research into these methods. Only one of the trials testing cigarettes designed to reduce risk measured their effect on the number of people quitting smoking. It found that people were not more likely to quit smoking if they used reduced-nicotine cigarettes than if they smoked their usual cigarettes. We did not find any trials which reported the long-term health effects of the treatments, and so it remains uncertain how much health benefit there is from reducing the number of cigarettes smoked each day or smoking cigarettes designed to be less harmful. Quality of evidence: The tobacco industry funded three of the included studies of cigarettes designed to reduce risk. None of the studies looked at whether there had been a long-term change in the health of the users. We rate the quality of the evidence looking at how many people quit smoking as 'low' or 'very low', generally because the findings are based on a small number of studies. We need more studies to investigate methods of reducing the harm caused by continued smoking. These need to measure the health of the users over a long period.

Interventions to reduce harm from continued tobacco use

Information on external validity of work site health promotion research is essential to translate research findings to practice. The authors provide a literature review of work site health behavior interventions. Using the RE-AIM framework, they summarize characteristics and results of these studies to document reporting of intervention reach, adoption, implementation, and maintenance. The authors reviewed a total of 24 publications from 11 leading health behavior journals. They found that participation rates among eligible employees were reported in 87.5% of studies; only 25% of studies reported on intervention adoption. Data on characteristics of participants versus nonparticipants were reported in fewer than 10% of studies. Implementation data were reported in 12.5% of the studies. Only 8% of studies reported any type of maintenance data. Stronger emphasis is needed on representativeness of employees, work site settings studied, and longer term results. Examples of how this can be done are provided.

Work Site Health Promotion Research: To what Extent can we Generalize the Results and what is Needed to Translate Research to Practice?:

Introduction Smoking restrictions in public places have been shown to reduce cigarette consumption and may reduce smoking prevalence. Evidence is emerging that smoke-free policies in nonpublic places may have a similar effect. The purpose of this study was to determine whether an association exists between household smoking rules and smoking patterns among adolescents (aged 15 to 18 years) and young adults (aged 19 to 24 years) living in parental homes (i.e., the homes of their parents, grandparents, or foster parents). Methods Cross-sectional data from the 1998-1999 Tobacco Use Supplement to the Current Population Survey were analyzed for the association between household smoking rules and smoking behaviors among adolescents and young adults. We used a probability sample of noninstitutionalized adolescents (aged 15 to 18 years) and young adults (aged 19 to 24 years) living in the United States and assessed smoking status, attempts to quit, and smoking intensity. Results After controlling for smoking status of others in the household, the odds of ever having smoked, being a current smoker, and smoking more than five cigarettes per day were significantly smaller in households with strict no-smoking policies than in households where smoking was permitted anywhere. These results were relevant for adolescents and young adults. Conclusion Household smoking rules are a type of antitobacco socialization that help deter adolescents from smoking. The influence of household smoking rules seems to extend beyond adolescence into the young adult years among people who continue to live at home with their parents, grandparents, or foster parents.

Impact of home smoking rules on smoking patterns among adolescents and young adults.

A randomized study was conducted in 41 workplaces to determine the potential of self-help and group-based programs to encourage reduced smoking in workplaces that have implemented smoking bans. The trial had limited success in recruiting smokers, attrition was an important limitation, and the study outcomes were modest. The authors conclude that more research is needed on effective strategies that help smokers minimize smoking at work.

Ilona Treijs

Papers

Promoting reduced smoking rates in the context of workplace smoking bans.