Research paper Workplace smoking policies and their association with male employees’ smoking behaviours: a cross-sectional survey in one company in China JiaNing Gao,1 PinPin Zheng,1 JunLing Gao,1 Simon Chapman,2 Hua Fu1 1School of Public Health, Fudan University, Shanghai, PR China 2Sydney School of Public Health, University of Sydney, New South Wales, Australia Correspondence to Professor Hua Fu, School of Public Health, Fudan University, PO Box 248, 138 Yixueyuan Road, Shanghai 200032, PR China; hfu@fudan.edu.cn Received 17 February 2010 Accepted 27 October 2010 Published Online First 21 November 2010 This paper is freely available online under the BMJ Journals unlocked scheme, see http:// tobaccocontrol.bmj.com/site/ about/unlocked.xhtml Tobacco Control 2011;20:131e136. doi:10.1136/tc.2010.036335 ABSTRACT Objectives The present work sought to evaluate different worksite smoking control policies and their associations with employees’ smoking behaviours and attitudes among Chinese male workers. Methods This was a cross-sectional survey with a self-administered standardised questionnaire, conducted among seven production workplaces of one multinational company in Shanghai in 2008. In total, 1043 male workers were involved. Current smoking prevalence, daily cigarette consumption, quitting intention and their potential association with workplace smoking control policies (smoke free or restricted smoking) were measured. Results Current smoking prevalence in workplaces where smoke-free policies had been imposed for 3 years was 55.5%, about 18% lower than in workplaces that only restricted smoking. Smokers in smoke-free workplaces also smoked 3.4 cigarettes less per day, made more quit attempts, were more conﬁdent of successfully quitting and more willing to accept a company sponsored cessation programme. Those patterns declined or were not found among the workplaces where smoking control policies had been imposed for 10 years. Smoker quitting intentions were not associated with workplace smoking policies regardless of the duration of the policies imposed. Conclusions A smoke-free workplace policy was found to have a signiﬁcant association with lower smoking prevalence and daily cigarette consumption, but not with employee quitting intentions. Restrictive smoking policies had no impact on employee smoking behaviours. The impact of workplace smoking control policies may vary over time. As the most preventable cause of premature death and disability, cigarette smoking is one of the most important public health challenges worldwide.1 After home, the workplace is where people spend most time and is thus the place where potential exposure to secondhand smoke (SHS) is greatest.2 Smoke-free workplaces are important because of their value in protecting non-smoking employees from SHS and because creation of smoke-free environments is one of the most effective strategies for reducing tobacco consumption, increasing smokers’ desire to quit and increasing their likeli- hood of cessation.3e5 With a population of 1.3 billion, China is the world’s largest producer and consumer of tobacco. As estimated in the China Tobacco Control Report 2007, there are more than 350 million smokers and about 540 million regular SHS smokers in China, which is still believed to be in an early stage of the tobacco epidemic.6 The working population aged 30 to 50 years has the highest smoking prev- alence.7 The proportions of relapsed quitters and former smokers are comparable in all occupational groups, with blue-collar workers having the lowest rate of quitting among various occupations. Work- places are often described as an ideal setting to help smoking employees reduce cigarette consumption, increase their desire to quit and increase their like- lihood of cessation by imposing policies prohibiting and restricting smoking in workplaces.8 Since the 1980s, the Chinese government has introduced a series of regulations to prohibit smoking in public settings such as public transport, theatres and hospitals. However, the implementation of these policiesdand therefore their impactdhas been far from satisfactory.9 Most workplace smoking control policies were inspired by safety and production concerns rather than to protect employees’ health. This has resulted in a diversity of smoking policies imposed in workplaces over the country. Partially because of that, there have been few studies evalu- ating workplace smoking policies and their impact on employee smoking behaviours in China. Furthermore, most research on workplace smoking control policies has been focused on the protection of non-smokers, rather than on smokers who also beneﬁt from the policies. This study sought to investigate smoking preva- lence and behaviours of Chinese workers whose workplaces had introduced types of smoking control policies for 3 or 10 years, to evaluate the relationship between these workplace smoking control policies and employees’ smoking behaviours. METHODS A smoking-related survey was conducted in a multi- national company in Shanghai as part of the company’s health promotion campaign during December 2007 to July 2008. All seven production plants located in Shanghai were included in this survey. The workforces involved ranged from 49 to 613. Because of safety and production require- ments, fully smoke free (n¼3) or restrictive smoking policies (n¼4) had been strictly implemented in all plants since their establishment. These policies had been equally and persistently implemented by all plants since their commencement. A ‘smoke-free policy’ was deﬁned as smoking being prohibited everywhere at the workplace site. In such work- places, smoking is only allowed outside the work- place fence. A‘restrictive smoking policy’ means that smoking is only permitted in a designated indoor 131