Impact of a workplace program on alcohol use and smoking among young adults

Background: Workplace consequences of alcohol and drug abuse include poor performance, fighting, insubordination, and occupational injuries, among other problems. To address the critical need for substance abuse prevention in the workplace, the Personal Responsibility and Values: Education and Training (PREVENT) program, originally designed for the U.S. Navy, was adapted to an 18-29 year-old railroad workforce. PREVENT is based on the Transtheoretical Model (TTM) stages-of-change approach. This study evaluates the adapted PREVENT program's impact on alcohol use and smoking. Methods: This case-control study compares self-reported alcohol use and smoking between PREVENT participants and a control group, pre- versus post-intervention. Non-equivalency at baseline between the groups is controlled for using a propensity score. Results: Controlling for demographic characteristics and pre-intervention smoking and drinking levels, PREVENT participants showed significant declines in smoking and drinking levels post-intervention compared to controls. In the previous 30 days, PREVENT participants had 75% fewer smoking days (relative rate=0.25, p=0.030), 69% fewer drinks (relative rate=0.31, p=0.001), 55% fewer drinking days (relative rate=0.45, p=0.003), and 64% fewer days consuming 5 or more drinks (relative rate=0.36, p=0.033) compared to controls. PREVENT participants were 52% less likely to face disciplinary action (OR=0.47, p=0.066) compared to controls. Conclusion: PREVENT reduced alcohol consumption and smoking among railroad workers aged 18-29. Decreases in alcohol use among PREVENT participants were consistently observed across all alcohol measures. This study provides evidence that PREVENT was successfully adapted and is an appropriate fit for transport workers.