Study of smoking behavior in asbestos workers

Background: Asbestos exposure and concomitant cigarette smoking markedly increase the risk of lung cancer and contribute to the prevalence and severity of pulmonary interstitial fibrosis. Methods: A cross-sectional survey of 214 asbestos workers was initiated to determine the prevalence of smoking and their readiness to quit smoking using the stage of change theory. Results: The study was comprised of 61 never smokers (28.5%), 118 ex-smokers (55.1%), and 35 current smokers (16.4%). Reasons for smoking cessation in ex-smokers included perception of ill-health (51%) and knowledge of smoking-asbestos hazards (3.4%). Stage of change of current smokers revealed: precontemplation (26.5%), contemplation (35%), preparation (29%), and action (8.8%). Current smokers had the highest prevalence of small airway obstruction on spirometry. Conclusions: A detailed smoking history during medical surveillance activities will enable the occupational physician to identify asbestos workers who have difficulty quitting and to develop a system in which such individuals can be referred to comprehensive smoking cessation programs.