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Tobacco Evidence-Based Practice Implementation and Employee Tobacco-Related Outcomes at Small Low-Wage Worksites

Kava, Christine M. PhD; Harris, Jeffrey R. MD; Gary Chan, Kwun C. PhD; Kohn, Marlana J. MPH; Parrish, Amanda T. MA; Hannon, Peggy A. PhD

Journal of Occupational and Environmental Medicine: July 2019 - Volume 61 - Issue 7 - p e312–e316
doi: 10.1097/JOM.0000000000001618

Objective: The aim of this study was to assess whether tobacco policy, program, and communication evidence-based practice implementation is associated with employee tobacco outcomes [current smoking; quit attempt; smokeless tobacco (SLT) use; and perceived worksite support for cessation] at small low-wage worksites.

Methods: We analyzed data from a randomized controlled trial testing an intervention to increase implementation of evidence-based health promotion practices. We used generalized estimating equations to examine relationships between practice implementation and tobacco outcomes.

Results: Communication practice implementation was associated with better perceived worksite support for cessation (P = 0.027). Policy and program implementation were associated with increased odds of being a current SLT user; these findings should be interpreted with caution given small sample sizes.

Conclusion: Tobacco communication evidence-based practice implementation was associated with favorable perceptions of worksite support for cessation; more may be needed to change tobacco use behavior.

Health Promotion Research Center, Department of Health Services, University of Washington, Seattle, Washington (Dr Kava, Dr Harris, Ms Kohn, Ms Parrish, Dr Hannon), and Department of Biostatistics, University of Washington, Seattle, Washington (Dr Gary Chan).

Address correspondence to: Christine M. Kava, PhD, Health Promotion Research Center, University of Washington, Box 354804, 1107 NE 45th St., Ste. 400, Seattle, WA 98105 (

This work was supported by the National Cancer Institute (grant number 5R01CA160217). This work was also supported by the Centers for Disease Control and Prevention's Prevention Research Center Program (Cooperative Agreement Number U48DP005013). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

The authors have no conflicts of interest.

Copyright © 2019 by the American College of Occupational and Environmental Medicine