Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies

Abstract

BackgroundTobacco 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.ConclusionsOur 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.

Job strain and the risk of severe asthma exacerbations: a meta‐analysis of individual‐participant data from 100 000 European men and women

“…There is some evidence that stressful life events increase the risk of asthma exacerbations in children 25 and adults 26. Stress is also associated with asthma triggers, such as respiratory infections 11 and smoking 12. However, we found no association between job strain and severe asthma exacerbations, which could suggest that at population level, job strain specifically or without other life stressors does not make asthma worse.…”

“…One psychosocial factor that may be implicated in asthma exacerbations is stress. Stress can make individuals prone to biological and behavioural triggers such as respiratory infections 11 and smoking 12, but the evidence for a direct link between stress and asthma exacerbations is unclear 1. Work is a common source of stress in adults, and epidemiological research has shown that stress is associated with an increased risk of certain diseases 13.…”

Uso de substâncias psicoativas entre trabalhadores da enfermagem

“…Esses trabalhadores encontram-se expostos aos diversos riscos ocupacionais tradicionais e aos riscos psicossociais que repercutem em stress, ansiedade e adoecimento mental, os quais têm sido considerados inerentes ao trabalho neste ambiente. Desse modo, o tabagismo pode ser utilizado como fuga tanto dos problemas laborais, como pessoais (Heikkilä et al, 2012;Perry, Lamont, Brunero, Gallagher, & Duffield, 2015). Em pesquisa realizada com enfermeiros norte-americanos que trabalhavam no período noturno há mais de 15 anos, identificou-se que esses profissionais tinham uma tendência ao tabagismo, o que se relaciona a sobrecarga de atividades, desgaste e stress.…”

Associations of job strain and lifestyle risk factors with risk of coronary artery disease: a meta-analysis of individual participant data

“…Predefined, harmonized measures were used to assess job strain (yes v. no) and 4 life style risk factors at baseline: current smoking (yes v. no), 19 physical inactivity (yes v. no), 20 heavy drinking (≥ 21 and ≥ 28 units of alcohol per wk for women and men, respectively), 21 and obesity (body mass index [BMI] ≥ 30). 22 A detailed description of these measures, including their validation and harmonization, has been published previously.…”