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Effects on cigarette consumption of a work–family supportive organisational intervention: 6-month results from the work, family and health network study
  1. David A Hurtado1,
  2. Cassandra A Okechukwu2,
  3. Orfeu M Buxton3,
  4. Leslie Hammer1,
  5. Ginger C Hanson4,
  6. Phyllis Moen5,
  7. Laura C Klein3,
  8. Lisa F Berkman6
  1. 1Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon, USA
  2. 2Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
  3. 3Department of Biobehavioral Health, Pennsylvania State University, State College, Pennsylvania, USA
  4. 4Kaiser Permanente Center for Health Research, Portland, Oregon, USA
  5. 5Department of Sociology, University of Minnesota, Minneapolis, Minnesota, USA
  6. 6Harvard Center for Population and Development Studies, Harvard University, Cambridge, Massachusetts, USA
  1. Correspondence to David A Hurtado, Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, L606, Portland, OR 97239, USA; hurtadod{at}


Background Observational studies have linked work–family issues with cigarette consumption. This study examined the 6-month effects on cigarette consumption of a work–family supportive organisational intervention among nursing home workers.

Methods Group randomised controlled trial where 30 nursing homes across New England states were randomly assigned to either usual practice or to a 4-month intervention aimed at reducing work–family conflict via increased schedule control and family supportive supervisory behaviours (FSSB). Cigarette consumption was based on self-reported number of cigarettes per week, measured at the individual level.

Results A total of 1524 direct-care workers were enrolled in the trial. Cigarette consumption was prevalent in 30% of the sample, consuming an average of 77 cigarettes/week. Smokers at intervention sites reduced cigarette consumption by 7.12 cigarettes, while no reduction was observed among smokers at usual practice sites (b=−7.12, 95% CI −13.83 to −0.40, p<0.05) (d=−0.15). The majority of smokers were US-born White nursing assistants, and among this subgroup, the reduction in cigarette consumption was stronger (b=−12.77, 95% CI −22.31 to −3.22, p<0.05) (d=−0.27). Although the intervention prevented a decline in FSSB (d=0.08), effects on cigarette consumption were not mediated by FSSB.

Conclusions Cigarette consumption was reduced among smokers at organisations where a work–family supportive intervention was implemented. This effect, however, was not explained by specific targets of the intervention, but other psychosocial pathways related to the work–family interface.

Trial registration number NCT02050204; results.


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  • Acknowledgements Special acknowledgement goes to Extramural Staff Science Collaborator, Rosalind Berkowitz King, PhD, and Lynne Casper, PhD, for design of the original Workplace, Family, Health and Well-Being Network Initiative. registration number: NCT02050204.

  • Contributors All authors made substantial contributions to this manuscript. DAH lead the analyses and the write-up of the manuscript. DAH, LFB, OMB and CAO formulated the main hypothesis and interpreted the findings. LH, PM, GCH and LCK provided critical feedback to the manuscript and also interpreted the findings. LFB, OMB, LH, PM were among the principal investigators for the study.

  • Funding This research was conducted as part of the Work, Family and Health Network (, which is funded by a cooperative agreement through the National Institutes of Health and the Centers for Disease Control and Prevention: Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant # U01HD051217, U01HD051218, U01HD051256, U01HD051276), National Institute on Aging (Grant # U01AG027669), Office of Behavioural and Social Sciences Research, and National Institute for Occupational Safety and Health (Grant # U01OH008788, U01HD059773). Grants from the National Heart, Lung, and Blood Institute (Grant #R01HL107240), William T Grant Foundation, Alfred P Sloan Foundation, and the Administration for Children and Families have provided additional funding. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of these institutes and offices.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.