MassBUILT: Efficacy of an Apprenticeship Site Based Smoking Cessation Intervention for Unionized Building Trades Workers

According to NHIS data from 1997 to 2004, occupations with smoking rates above 30% were all blue-collar, with construction workers having the highest prevalence at 38.8%. Blue-collar workers start smoking at an earlier age, smoke more cigarettes and experience higher exposure to work-related carcinogens but are less likely to successfully quit smoking.

To address this problem, we used a group randomized controlled design to test a training-site based smoking cessation intervention among building and construction trades apprentices at ten sites (n=1213). We assessed the odds of smoking cessation at one month and six months post intervention using SAS GLIMMIX and controlling for clustering by worksite. To account for missing data on covariates, we imputed data using Amelia II then used MIANALYZE to combine the results from multivariable and multinomial logistic regression models.

The baseline prevalence of smoking was 41%. We observed significantly higher quit rates in the intervention versus control group (26% vs. 16.8%; p=0.014) one month after the intervention. However, the effects diminished over time so that the difference in quit rate was not significant at six month post intervention. Intervention group members nevertheless reported a significant decrease in smoking intensity (OR =3.13; 95% CI 1.55 to 6.31) at six months post-intervention.

The study demonstrates the feasibility of delivering an intervention through apprentice programs. The notably better one-month quit rate among intervention members and the greater decrease in smoking intensity among them underscore the need to develop strategies to help reduce relapse among blue-collar workers who quit smoking.