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PLoS By Category | Recent PLoS Articles
Mental Health - Public Health and Epidemiology - Respiratory Medicine

Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies
Published: Friday, July 06, 2012
Author: Katriina Heikkilä et al.

by Katriina Heikkilä, Solja T. Nyberg, Eleonor I. Fransson, Lars Alfredsson, Dirk De Bacquer, Jakob B. Bjorner, Sébastien Bonenfant, Marianne Borritz, Hermann Burr, Els Clays, Annalisa Casini, Nico Dragano, Raimund Erbel, Goedele A. Geuskens, Marcel Goldberg, Wendela E. Hooftman, Irene L. Houtman, Matti Joensuu, Karl-Heinz Jöckel, France Kittel, Anders Knutsson, Markku Koskenvuo, Aki Koskinen, Anne Kouvonen, Constanze Leineweber, Thorsten Lunau, Ida E. H. Madsen, Linda L. Magnusson Hanson, Michael G. Marmot, Martin L. Nielsen, Maria Nordin, Jaana Pentti, Paula Salo, Reiner Rugulies, Andrew Steptoe, Johannes Siegrist, Sakari Suominen, Jussi Vahtera, Marianna Virtanen, Ari Väänänen, Peter Westerholm, Hugo Westerlund, Marie Zins, Töres Theorell, Mark Hamer, Jane E. Ferrie, Archana Singh-Manoux, G. David Batty, Mika Kivimäki, for the IPD-Work Consortium

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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