title: Results of a union-based smoking cessation intervention for apprentice iron workers (United States).
abstract: OBJECTIVE
  Blue-collar workers are more likely to smoke, smoke more heavily, and have less success in quitting compared to white-collar workers, and this occupational gap is growing over time. Effective smoking cessation interventions among blue-collar workers are needed to address growing class-based disparities.
  
  
  METHODS
  We used a pre-post study design to test feasibility and effect size of a smoking cessation trial in a union apprenticeship training program for iron workers (n = 337). The 4-month intervention drew upon a health promotion-health protection model for smoking cessation among blue-collar workers. We conducted pairwise analyses to assess pre-post intervention differences in 7-day point prevalence smoking abstinence measured 1 month after intervention was completed. Additional secondary outcomes, including smoking frequency, intensity, intention and self-efficacy to quit, were also assessed.
  
  
  RESULTS
  Baseline smoking prevalence was 41%. We observed a 19.4% post-intervention quit rate among baseline smokers. There were statistically significant positive changes pre- and post-intervention in intention to quit smoking, self-efficacy to quit, and a reduction in the number of days smoked. Participation in pro-active intervention components was associated with a three-fold (OR = 3.0, 1.15, 7.83) increase in the likelihood of quitting. Overall, participation in intervention components was low.
  
  
  CONCLUSIONS
  Labor union apprenticeship programs represent a promising venue for smoking cessation interventions, particularly those that draw upon a health promotion-health protection model.
authors.affiliation: Centre for Community Based, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115, USA. elizabeth_barbeau@dfci.harvard.edu
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Barbeau
authors.forename: Yi
authors.initials: Y
authors.lastname: Li
authors.forename: Patricia
authors.initials: P
authors.lastname: Calderon
authors.forename: Cathy
authors.initials: C
authors.lastname: Hartman
authors.forename: Margaret
authors.initials: M
authors.lastname: Quinn
authors.forename: Pia
authors.initials: P
authors.lastname: Markkanen
authors.forename: Cora
authors.initials: C
authors.lastname: Roelofs
authors.forename: Lindsay
authors.initials: L
authors.lastname: Frazier
authors.forename: Charles
authors.initials: C
authors.lastname: Levenstein
mesh_terms: D000328:Adult; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007750:Labor Unions; D008404:Massachusetts; D008875:Middle Aged; D009786:Occupational Health Services / Q000458:organization & administration*; D016540:Smoking Cessation; D016896:Treatment Outcome; D014481:United States; D017132:Workplace