Effectiveness of smoking cessation advice for asbestos workers

Our plain-English summary of Effectiveness of smoking cessation advice for asbestos workers, by A. Johnson, P. Farrow, R. Jenkins (Occupational Medicine, 2006).

The study

• Authors: A. Johnson, P. Farrow, R. Jenkins
• Journal: Occupational Medicine
• Published: 2006;56(1):59-60
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aim: To assess effectiveness of smoking cessation advice to asbestos workers at statutory medical examinations.

Methods: Workers are required to be examined every 2 years while continuing potential exposure to asbestos, including cessation advice if smokers. Records of 170 workers seen between 1986 and 2004 in Kent and Canterbury Hospital were reviewed. Respiratory symptoms, signs, lung function, radiological findings and smoking status were analysed.

Results: At initial visit 109 (64%) were smokers. Thirty-four of these attended twice. Despite verbal advice, including emphasis on respiratory abnormalities detected in 62%, only three (9%) had ceased smoking by self-reporting at the second visit.

Conclusion: Despite appropriate counselling regarding the potential risks of asbestos exposure and smoking, the cessation rate among asbestos workers was disappointingly low. Further measures to encourage asbestos workers to enter smoking cessation programmes should be considered.

In plain English

This short report was an audit of records from the statutory two-yearly medical examinations of asbestos workers in the UK. The authors reviewed records of 170 workers examined at the Kent and Canterbury Hospital between 1986 and 2004. All were seen by one doctor who routinely gave smokers clear verbal advice to quit, including the greatly increased lung cancer risk for smokers who inhale asbestos. All workers were male, with an average age of 37. At the first visit, 109 (64%) smoked. Only 48 workers returned for a second examination. Of these, 34 had been smokers, and only 3 of those 34 (9%) reported having stopped. Of the same 34, 21 (62%) had some abnormality in symptoms, examination, lung function or chest X-ray. The authors concluded that the quit rate was disappointingly low and that further measures to get asbestos workers into cessation programmes should be considered. They noted small numbers and no control group. Quitting was self-reported and not checked, so the figure may overestimate the true quit rate.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Audit of medical records from consecutive statutory asbestos medical examinations (short report), with no control group
• Who was studied: 170 asbestos workers, all male, average age 37 years (range 16 to 61), examined under the Asbestos Regulations at the Kent and Canterbury Hospital, East Kent, UK, between 1986 and 2004, all by a single appointed doctor; 48 attended a second examination
• Exposure: Clear verbal smoking cessation advice given to smokers at statutory medical examinations of workers with continuing potential exposure to asbestos. The advice included the greatly increased risk of lung cancer in smokers with asbestos inhalation. Asbestos fiber types and doses were not reported.
• Main results:
  • At the first visit, 109 of the 170 workers (64%) were current smokers and 61 (36%) were non-smokers
  • 122 workers did not attend a second examination, leaving 48. Of these 48, 34 (71%) were smokers initially, and only 3 of the 34 (9%) reported having stopped smoking at the second visit.
  • Of the 34 initial smokers followed up, 21 (62%) had some abnormality (chest symptoms or signs, reduced lung function, or radiological pulmonary or pleural changes)
  • In the whole cohort of 170, 85 (50%) had any abnormality: 22 of 61 non-smokers (36%) and 63 of 109 smokers (58%)
• The authors' conclusion: The authors concluded that, despite appropriate counselling about the risks of asbestos exposure and smoking, the quit rate among asbestos workers was disappointingly low. They said further measures to encourage asbestos workers to enter smoking cessation programmes should be considered, and recommended referring workers willing to quit to a comprehensive cessation programme.
• Limitations the authors state:
  • Small numbers and lack of a control group
  • Comparison with other cessation studies is hindered by lack of age and sex comparability
  • Quitting was self-reported and not validated, so the data may overestimate the true quit rate

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure.

Related studies

• Healthcare provider smoking cessation advice among US worker groups — D.J. Lee, L.E. Fleming, et al. (2007)
• Effectiveness of postal smoking cessation advice: a randomized controlled trial in young men with reduced FEV1 and asbestos exposure — S. Humerfelt, G.E. Eide, et al. (1998)
• A pilot study of telephone-based smoking cessation intervention in asbestos workers — O.Y. Osinubi, J. Moline, et al. (2003)
• Study of smoking behavior in asbestos workers — O.Y. Osinubi, A.A. Afilaka, et al. (2002)
• Health promotion: Smoking control — (1983)
• The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking — A. Reid, N.H. de Klerk, et al. (2006)

Browse more research in Occupational Medicine, or return to medical research.