Dissertation
Organizational level factors and their association with smoking-related initiatives and outcomes at small and very small workplaces
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Autumn 2017
DOI: 10.17077/etd.5721wjl7
Abstract
<p>Smoking cigarettes has a negative impact on the population’s health and on the economy. To reduce the burdens associated with smoking, many workplaces have adopted anti-smoking initiatives (i.e., smoking policies and smoking cessation activities). Unfortunately, smaller workplaces are less likely to have implemented these initiatives, with the likelihood of adoption increasing as the size of the workplace increases. Two characteristics hypothesized to influence anti-smoking initiative adoption are organizational culture and workplace health climate. Culture refers to the values, assumptions, and subconscious norms that operate within an organization, while workplace health climate refers to the shared perceptions of an organization’s practices and priorities for health.</p>
<p>The first study of this dissertation used a qualitative approach to describe and compare the smoking policies and smoking cessation activities at small (20-99 employees) and very small (< 20 employees) workplaces (specific aim 1). Key informants coming from small and very small workplaces (N=32) completed telephone interviews, with data analyzed using content and thematic analysis. Almost all participants (97%, n=31) described a smoking policy at their workplace. A lower proportion of workplaces offered activities to help employees quit smoking (66%, n=21). Reasons for anti-smoking initiative adoption included the implementation of a statewide smoking ban, to improve employee health, and organizational benefits (e.g., reduced insurance costs). Few challenges existed adopting and implementing these activities. Facilitators to adoption and implementation included the passing of a statewide smoking ban, no issues with compliance among employees, and support from others (e.g., management). Compared to small workplaces, very small workplaces were less likely to offer cessation activities. Reasons cited for this lack of adoption included having no current smokers within the organization (i.e., activities not needed) and a lack of interest in quitting among current smokers.</p>
<p>The second study in this dissertation examined the association between organizational culture types and smoking policy strength and smoking cessation activities (specific aim 2), and the associations between organizational culture, workplace health climate, and employee smoking (i.e., smoking status, smoking intensity, and intention to quit smoking) (specific aim 3) at small (20-99 employees) and very small workplaces (< 20 employees). This study conceptualized organizational culture with the Competing Values Framework, which theorizes that four cultural archetypes represent two major dimensions of organizational effectiveness: clan, adhocracy, hierarchical, and market. Executives coming from small and very small workplaces first participated in a brief questionnaire related to their workplace’s anti-smoking initiatives. Executives then sent a link to a separate survey to their employees, which asked questions about organizational culture, workplace health climate, and their smoking behavior. This study used regression analysis to examine associations. The final sample size for analysis was 259 executives and 280 employees coming from 68 workplaces.</p>
<p>Culture was not significantly related to smoking policy strength. An increase in clan culture was associated with lower odds of offering smoking cessation activities (OR=0.09; 95% CI: 0.01, 0.65). Workplaces strong in clan culture did not have a significantly better workplace health climate. A better workplace health climate was associated with lower odds of being a current smoker (OR=0.10; 95% CI: 0.02, 0.57), but was not related to smoking intensity or quit intention.</p>
<p>In consideration of the findings from both studies, the following conclusions were made: 1) the smallest workplaces offer the least protection in relation to tobacco control; 2) state and federal policies are needed to advance tobacco control; 3) organizational characteristics play an important role in shaping behaviors and outcomes related to smoking; 4) integrating organizational change strategies into comprehensive tobacco control initiatives may produce the greatest changes in employee smoking. Action is needed to increase smoking policies and programs at very small workplaces, with strategies designed to change the culture and climate of the workplace implemented.</p>
Details
- Title: Subtitle
- Organizational level factors and their association with smoking-related initiatives and outcomes at small and very small workplaces
- Creators
- Christine Marie Kava - University of Iowa
- Contributors
- Edith A. Parker (Advisor)Barbara Baquero (Committee Member)Susan J. Curry (Committee Member)Paul Gilbert (Committee Member)Daniel Sewell (Committee Member)Michael Sauder (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Community and Behavioral Health
- Date degree season
- Autumn 2017
- Publisher
- University of Iowa
- DOI
- 10.17077/etd.5721wjl7
- Number of pages
- xiv, 214 pages
- Copyright
- Copyright © 2017 Christine Marie Kava
- Language
- English
- Date submitted
- 05/04/2018
- Description illustrations
- illustrations
- Description bibliographic
- Includes bibliographical references (pages 194-214).
- Public Abstract (ETD)
Considered the leading cause of preventable death, smoking cigarettes can have a negative impact on the health of the population. Smoking can also have a negative impact on the economy, partly due to medical costs related to smoking. To reduce the consequences of smoking, many workplaces have adopted anti-smoking policies and programs, which protect employees from secondhand smoke exposure and help employees quit smoking.
Unfortunately, smaller workplaces have fewer anti-smoking policies and programs compared to large workplaces. The results from this dissertation show that statewide bans on smoking are an important reason smaller workplaces have smoking policies. The smallest workplaces (places with less than 20 employees) offered fewer programs to help employees quit smoking. One reason described for not having these programs was not having smokers working for the organization.
Two characteristics related to smaller workplaces having smoking policies and programs are organizational culture and workplace health climate. Culture relates to the values people hold about their workplace, while workplace health climate relates to how supportive workers are about improving health. The results from this dissertation suggest that culture can influence a workplace’s decision to offer programs to help employees quit smoking. Certain types of culture increased the chances of smoking in the workplace, while having a better workplace health climate reduced these chances. Action is needed to increase smoking policies and programs at very small workplaces, with strategies designed to change the culture and climate of the workplace implemented.
- Academic Unit
- Community and Behavioral Health
- Record Identifier
- 9983776843502771
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