Introduction: Transit workers are a blue-collar occupational group with elevated rates of smoking despite access to free or low-cost cessation services available through their health insurance as a union-negotiated employee benefit. Little is known about the influences on cessation participation in this workforce. Aims: The purpose of this study is to analyse the factors associated with past-year cessation activities amongst a multiethnic sample of transit workers. Methods: Cross-sectional tobacco surveys were completed by 935 workers at an Oakland, California, USA-based public transit agency. Data from 190 current smokers (68% African American; 46% female) were analysed. Adjusted odds ratios were calculated to identify factors associated with past-year cessation activity. Results: Approximately 55% of smokers stopped smoking for one day or longer during the past year in order to quit. Nearly half reported that the most common barrier to quitting was, 'Not mentally ready to quit because I like smoking'. Workers in the contemplation/precontemplation stage for intention to quit were less likely to have engaged in cessation activities than those in the action/preparation stage (AOR = 0.34). Frequency of coworker encouragement for quitting was positively associated with past-year cessation activities (AOR = 3.25). Frequency of insomnia symptoms was negatively associated with cessation activity participation (AOR = 0.34). Conclusions: Most transit workers who smoke made a past-year quit attempt. Gaining insight into factors associated with participation in cessation activities can aid worksite efforts to promote cessation and reduce tobacco-related disparities.

Transit workers constitute a blue-collar occupational group that have elevated smoking rates relative to other sectors of employed adults in the United States. This study analyzed cross-sectional tobacco survey data from 935 workers (60% African American; 37% female) employed at an urban public transit agency in California. Prevalence of current and former smoking was 20.3% and 20.6%, respectively. Younger workers were less likely than older workers to be current or former smokers. Having a complete home smoking ban was associated with decreased likelihood of being a smoker [odds ratio (OR) = 0.04, 95% confidence interval (CI) = 0.01-0.17], as were neutral views about whether it is easy for a smoker to take a smoking break during their shift (OR = 0.50, 95% CI 0.28-0.88). Current smoking among the sample is > 50% higher than the adult statewide prevalence. Potential points of intervention identified in this study include perceived ease of worksite smoking breaks and establishing home smoking bans. Tailored cessation efforts focusing on older transit workers more likely to smoke are needed to reduce tobacco-related disparities in this workforce.

Poor sleep quality is associated with numerous physical and mental health problems. The purpose of this study is to analyze the occupational and demographic factors associated with sleep problems among a sample of urban transit operators. The sample consists of 676 workers (44% female, 67% African American) at a Northern California public transit agency who participated in a cross-sectional worksite tobacco survey. Approximately 27% of the sample reported that they often had trouble going to sleep or staying asleep in the past 12 months. Results of multivariate logistic regression analysis showed that frequency of job stressors (e.g., equipment problems, road or traffic problems, poor access to bathrooms) and amount of time needed to unwind and relax after work were significantly associated with often experiencing insomnia symptoms (odds ratio [OR] = 1.76 and 2.44, respectively). Younger workers, females, and nicotine-dependent smokers were more likely to report often experiencing sleep problems than older workers, males, and nonsmokers. Employment length and work shift were not associated with the outcome. The findings indicate that transit operators experience elevated prevalence of past-year sleep problems, and occupational factors play a role in their occurrence. Future research should explore if policies that help reduce frequency of job stressors can mitigate poor sleep quality among this occupational group.

Background

Urban emergency department (ED) patients have elevated smoking and substance use compared with the general population. We analyzed gender differences in smoking among an urban ED sample and assessed the contribution of substance use, demographic, and couple factors.

Methods

We conducted a secondary analysis of data obtained from a cross-sectional, observational survey (N = 1037 participants) on drinking, drug use, and intimate partner violence (IPV). Gender-specific logistic regression models for current (past 30-day) smoking and multinomial regression models for smoking intensity (light: ⩽5 cigarettes per day [CPD]; moderate: 6 to 10 CPD; heavier: >10 CPD) were estimated.

Results

Smoking prevalence was higher among men than women (35.5% vs 18.9%; P < .001). Substance use (frequency of intoxication, marijuana, amphetamine, and cocaine use), demographic (food insufficiency, unemployment), and couple-related factors (having a spouse/partner who smoked, IPV involvement, being in a same-gender couple) were differentially associated with current smoking and level of intensity among men and women.

Conclusions

Emergency department staff should consider the impact of polysubstance use, food insufficiency, unemployment, and whether both partners in the couple smoke when screening patients for smoking and formulating cessation treatment plans. Women in same-gender relationships and those who have experienced IPV involvement may require additional referral.