Enterprise ownership, workplace culture, and smoking cessation difficulty in China: A cross-sectional data analysis.

Abstract

Introduction: Workplaces are important settings for smoke-free protection and cessation support, but enterprise ownership may shape quit attempts. This cross-sectional data analysis examined whether employees of state-owned enterprises experience greater smoking cessation difficulty than employees of private enterprises.

Methods: We analyzed cross-sectional self-reported data from an anonymous online questionnaire administered in October 2025. The questionnaire link was distributed through employee WeChat groups in six enterprises in Zhejiang Province, China (three state-owned and three private). Eligible participants were full-time employees aged ≥18 years who had worked in the enterprise for at least six months. The analytic sample comprised 989 employees. Outcomes were workplace cessation culture, indoor workplace secondhand smoke exposure in the past 30 days, quit intention within six months, and past-year quit attempt among current smokers. Ownership-group differences were assessed descriptively and using multivariable linear regression and logistic generalized estimating equations.

Results: The sample included 483 state-owned and 506 private enterprise employees. Current smoking was more common in state-owned enterprises (34.8% vs 27.5%, p=0.046). State-owned enterprise employees reported lower cessation culture (3.33 vs 3.64, p<0.001), less cessation support (2.5 vs 3.6, p<0.001), stronger pro-smoking norms (2.90 vs 2.49, p<0.001), and more indoor workplace secondhand smoke exposure (42.0% vs 25.5%, p<0.001). Among current smokers, quit intention (36.9% vs 52.5%, p=0.009) and past-year quit attempts (29.8% vs 57.6%, p<0.001) were less common in state-owned enterprises. After adjustment, private enterprise employment was associated with higher odds of quit intention (adjusted odds ratio, AOR=1.51; 95% CI: 1.05-2.19) and past-year quit attempt (AOR=2.82; 95% CI: 1.65-4.84).

Conclusions: State-owned enterprise employees experienced greater cessation difficulty than private enterprise employees. Higher secondhand smoke exposure, stronger pro-smoking norms, weaker cessation support, and lower leadership commitment may contribute to this ownership-related difference.