Integrating worksite smoking cessation services into the construction trade: opportunities and challenges

Background: Almost 39% of US construction workers (CWs) smoke. Hispanic/Latino CWs represent 23% of the US CWs, and they have lower access to cessation services mainly due to their transient and lack of culturally-sensitive intervention. One potential strategy is the provision of a work-based culturally-tailored smoking cessation services. This study aimed to gain insight into the construction site management's current practices related to anti-smoking policies and smoking cessation services. It also sought views on “ideal” workplace cessation services, implementation commitment, and anticipated challenges. Methods: We conducted semi-structured, 45-minute interviews with 25 key personnel at five construction sites in South Florida. Interviews were recorded, transcribed and analyzed thematically using Braun's six phases approach. Results: Participants were all males and represented a range of professions including construction executive, senior/safety manager, and contractor/subcontractor. Smoking was prohibited only inside the construction buildings and participants perceived most workers as adherent to the policy. Although employers were concerned about the effects of smoking on productivity loss, safety, and insurance costs, nothing was provided to help smokers quit smoking. Only one-quarter of participants believed that worksite management would support implementing smoking cessation services. The majority considered distributing self-help materials with free medications as the most appropriate service and recommended providing the service in Spanish during lunch/breakfast breaks. Challenges to integrate services were smokers' low interest in quitting, time restriction, and cost. Recommendations to support implementing services were local or state government mandate, obtaining company approval, involving safety managers and subcontractors in the process, and providing services during employment orientation training. Conclusions: Tailoring sustainable onsite smoking cessation services in the construction sector presents unique, but not insurmountable challenges. Involvement of key stakeholder groups including policymakers as well as construction management, supervisors, and subcontractors is necessary to support integrating smoking cessation services in this setting.