Job strain and tobacco smoking: an individual-participant data meta-analysis of 166,130 adults in 15 European studies.

Heikkilä, K; Nyberg, ST; Fransson, EI; Alfredsson, L; De Bacquer, D; Bjorner, JB; Bonenfant, S; Borritz, M; Burr, H; Clays, E; +40 more...Casini, A; Dragano, N; Erbel, R; Geuskens, GA; Goldberg, M; Hooftman, WE; Houtman, IL; Joensuu, M; Jöckel, K; Kittel, F; Knutsson, A; Koskenvuo, M; Koskinen, A; Kouvonen, A; Leineweber, C; Lunau, T; Madsen, IE; Magnusson Hanson, LL; Marmot, MG; Nielsen, ML; Nordin, M; Pentti, J; Salo, P; Rugulies, R; Steptoe, A; Siegrist, J; Suominen, S; Vahtera, J; Virtanen, M; Väänänen, A; Westerholm, P; Westerlund, H; Zins, M; Theorell, T; Hamer, M; Ferrie, JE; Singh-Manoux, A; Batty, GD; Kivimäki, M; IPD-Work Consortium and (2012) Job strain and tobacco smoking: an individual-participant data meta-analysis of 166,130 adults in 15 European studies. PloS one, 7 (7). e35463-. ISSN 1932-6203 DOI: 10.1371/journal.pone.0035463
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BACKGROUND: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults. METHODOLOGY AND PRINCIPAL FINDINGS: We analysed cross-sectional data from 15 European studies comprising 166,130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166,130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking. CONCLUSIONS: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.


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