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[Application of theory of organizational change for smoking cessation in workplace].

OBJECTIVE
To explore the feasibility and effectiveness of tobacco control program in manufacture workplace with stage theory of organizational change.


METHODS
Community intervention study was carried out among two manufacture plants of a multinational chemical company in Shanghai during 2008 to 2009. Totally 246 employees in control group and 233 in intervention group were involved. The average age was (34.7 +/- 13.2) years old and (31.1 +/- 11.9) years old, respectively. Four stages of the theory of organizational change were implemented in the intervention group. Self-administered questionnaire was employed prior to and after the interventions to collect the data on employees' smoking behaviours such as smoking prevalence, daily cigarette consumption, perception on smoking's health impact, as well as their quitting intention. After six months, urine cotinine test was given to assess the successful cessation.


RESULTS
The current smoking prevalence rate in intervention group was reduced from 59.8% before the study to 39.1% in follow-up (P < 0.01), while their daily cigarette smoked dropped from (15.0 +/- 8.6) cigarettes per day to (11.9 +/- 7.9) cigarettes per day (P < 0.01), while no significant changes in control group. In intervention group, the proportion of willing to accept cessation support from the work mates increased from 3.7% before the intervention to 15.6% afterwards, the perception of smoking having severe health impact increased from 36.5% to 64.4% (P < 0.05); No significant changes were found in control group. The quitting intention was also raised from 11.0% to 41.5% (P < 0.01). The successful cessation rate after six months were 24.6% in intervention group and 6.4% in control group (P < 0.05).


CONCLUSION
Stage theory of organizational change is feasible to be implemented within tobacco control program in manufacture workplace. Its application has effectiveness to decrease smoking prevalence and daily cigarette consumption with quitting intention raised. Successful cessation result was also indicated.