Association Between Employer's Knowledge and Attitude Towards Smoking Cessation and Voluntary Promotion in Workplace: a Survey Study

Background: Workplace smoking cessation (SC) intervention is effective in increasing quit rate but little was known about the factors associated with voluntary SC promotion. Comprehensive smoke-free legislation, including banning smoking in all indoor area of workplaces, has been enforced in Hong Kong. This survey investigated the prevalence of company's compliance with smoke-free legislation and examined the relation between voluntary SC promotion in workplace and employer's knowledge of and attitude towards smoking and SC.

Methods: Half (50.3%,  = 292) of a convenience sample of companies completed a self-administered questionnaire on company's voluntary SC promotion in the workplace. Factors investigated included company's characteristics (size, type, and number of smoking employees); employers' knowledge of smoking, second-hand smoke and SC effects on health; perceived responsibility in assisting employees to quit smoking and smoking prohibition in workplace (smoke free policy). Logistic regression yielded adjusted odds ratio (aOR) for voluntary SC promotion.

Results: A notable proportion of companies (14.7%) showed non-compliance with the smoke free workplace ordinance and only 10% voluntarily promoted SC. Perceived greater negative impact of smoking on the company (adjusted odds ratio[aOR] 1.94, 95% confidence interval [CI] 1.18-3.20) and better knowledge of smoking (aOR 1.40, 95%CI 1.00-1.94) were associated with voluntary SC promotion. Positive but non-significant associations were observed between perceived responsibility of assisting employees to quit, workplace smoke free policy and voluntary SC promotion. Company characteristics were generally not associated with voluntary SC promotion except white collar companies were less likely to promote SC (aOR 0.26, 95% CI 0.08-0.85).

Conclusions: This is the first survey on company's SC promotion in the Chinese population. A notable proportion of companies was not compliant with the smoke-free workplace ordinance. Employers with a higher level of knowledge and perceived impact of smoking on companies and from blue-collar companies were more likely to promote SC in workplace. The findings inform future workplace intervention design and policy.

Trial Registration: The study was retrospectively registered at ClinicalTrials.gov (NCT02179424) dated 27 June 2014.