The specific aims of this study are to ascertain differences in smoking cessation rates and costs per quitter among worksites that are randomized to either a smoking cessation intervention delivered by paid external staff or the same smoking cessation intervention delivered through community organization strategies. Forty-five worksites, employing 100 to 250 employees with high rates of smoking prevalence, will be randomized to one of the two intervention conditions or a control condition. A 20-month intervention period will be preceded in the intervention arms and followed in all arms by brief surveys on employee smoking patterns. The detrimental effects of smoking are well documented and there is significant evidence that smoking cessation greatly reduces the health consequences of smoking. One venue for smoking cessation has been the worksite, especially worksites that employ large numbers of smoking workers. Worksite smoking cessation interventions have achieved some success, especially those that include multiple components directed at both individual and environmental change. Many researchers have call for the inclusion of community organization strategies in worksite health promotion change programs. While the community organization approach is very appealing on a theoretical level, little evidence exists that such an approach is more or less effective than interventions not utilizing community organization strategies. Further, it is not obvious nor are there any data available to support assertions, that any additional effectiveness of such an approach is cost-effective, given the resources that must go into organizing a worksite. The extra resources and expenditures required for the community organization aspects of behavioral change programs may not result in justifiably large differences in behavior change. To ascertain the relative worksite-wide effectiveness and cost effectiveness of a smoking cessation intervention delivered by external staff or an intervention delivered through community organization strategies, worksites will be randomly allocated into one of these two arms. In addition, a control arm will ascertain the secular trend. Pilot work on intervention elements has been substantial and produced good employee response and high cessation rates. A process for recruiting worksites to participate in such a project has been developed and piloted. Pilot work has been conducted on the feasibility of implementing the intervention through community organization strategies. The study will be conducted in three waves to increase manageability and to reduce the human resource burden. The two primary endpoints of the project are: smoking cessation rates in the two intervention arms of the study; and costs associated with smoking cessation interventions. A control arm will be used to assess the secular trend in cessation rates. Smoking status will be assessed at baseline and at the end of the study, with procedures to follow employees who leave the worksite and to add new employees to the study.

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Satia, Jessie A; Kristal, Alan R; Patterson, Ruth E et al. (2002) Psychosocial factors and dietary habits associated with vegetable consumption. Nutrition 18:247-54
Peterson Jr, A V; Kealey, K A; Mann, S L et al. (2000) Hutchinson Smoking Prevention Project: long-term randomized trial in school-based tobacco use prevention--results on smoking. J Natl Cancer Inst 92:1979-91
Satia, J A; Patterson, R E; Taylor, V M et al. (2000) Use of qualitative methods to study diet, acculturation, and health in Chinese-American women. J Am Diet Assoc 100:934-40
Levy, L; Patterson, R E; Kristal, A R et al. (2000) How well do consumers understand percentage daily value on food labels? Am J Health Promot 14:157-60, ii
Neuhouser, M L; Kristal, A R; Patterson, R E (1999) Use of food nutrition labels is associated with lower fat intake. J Am Diet Assoc 99:45-53
Patterson, R E; Levy, L; Tinker, L F et al. (1999) Evaluation of a simplified vitamin supplement inventory developed for the Women's Health Initiative. Public Health Nutr 2:273-6
Kristal, A R; Glanz, K; Curry, S J et al. (1999) How can stages of change be best used in dietary interventions? J Am Diet Assoc 99:679-84
Neuhouser, M L; Patterson, R E; Levy, L (1999) Motivations for using vitamin and mineral supplements. J Am Diet Assoc 99:851-4
Patterson, R E; Kristal, A R; Levy, L et al. (1998) Validity of methods used to assess vitamin and mineral supplement use. Am J Epidemiol 148:643-9
Patterson, R E; Kristal, A R; Shannon, J et al. (1997) Using a brief household food inventory as an environmental indicator of individual dietary practices. Am J Public Health 87:272-5

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