Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample

Abstract

Introduction Inadequate sleep (≤6 and ≥9 h) is more prevalent in smokers than non-smokers but the extent to which sleep duration in smokers relates to smoking behaviors and cessation outcomes, is not yet clear. To begin to address this knowledge gap, we investigated the extent to which sleep duration predicted smoking behaviors and quitting intention in a population sample. Methods Data from current smokers who completed the baseline (N=635) and 5-year follow-up (N=477) assessment in the United Kingdom Biobank cohort study were analyzed. Multivariable regression models using smoking behavior outcomes (cigarettes per day, time to first cigarette, difficulty not smoking for a day, quitting intention) and sleep duration (adequate (7–8 h) versus inadequate (≤6 and ≥9 h) as the predictor were generated. All models adjusted for age, sex, race, and education. Results Worsening sleep duration (adequate to inadequate) predicted a more than three-fold higher odds in increased cigarettes per day (OR =3.18; 95% CI =1.25–8.06), a more than three-fold increased odds of not smoking for the day remaining difficult (OR =3.90; 95% CI =1.27–12.01), and a > 8-fold increased odds of higher nicotine dependence (OR= 8.98; 95% CI =2.81–28.66). Improving sleep duration (i.e., inadequate to adequate sleep) did not predict reduced cigarette consumption or nicotine dependence in this population sample. Conclusion Transitioning from adequate to inadequate sleep duration may be a risk factor for developing a more “hard-core” smoking profile. The extent to which achieving healthy sleep may promote, or optimize smoking cessation treatment response, warrants investigation.

The role of substance use, smoking, and inflammation in risk for suicidal behavior

“…This increased prevalence in people with mental illness is attributed to several factors including disparities in access to tobacco cessation programs, lower socioeconomic status, and increased rates of stressful life events (Prochaska et al, 2017). Our results are also consistent with prior studies showing smoking to be associated with increased risk for suicidal behavior, suicide, and with increased aggression, impulsivity, and poor sleep (Bloom et al, 2013;Dakwar et al, 2011;Miller et al, 2000aMiller et al, , 2000bMitchell, 1999;Oquendo et al, 2004;Patterson et al, 2018;Poorolajal and Darvishi, 2016). Furthermore, aggression, impulsivity, and poor sleep are risk factors for suicidal behavior (Carli et al, 2010;Goldstein et al, 2008;Melhem et al, 2007;Nock and Kessler, 2006).…”

Association Between Sleep Duration and Ideal Cardiovascular Health Among US Adults, National Health and Nutrition Examination Survey, 2013–2016

“…The biologic mechanism for the effect of sleep duration on CVH has multiple pathways. Sleep duration is independently associated with several CVH metrics, such as weight status and hypertension, and with insulin sensitivity, which can lead to type 2 diabetes (5,6,28). Poor sleep may also lead to changes in behavioral components such as increased frequency of smoking or decreased physical activity (29).…”

Evidence for Genetic Correlations and Bidirectional, Causal Effects Between Smoking and Sleep Behaviors

“…2,3 One longitudinal study that followed substance naïve adolescents into early adulthood found that erratic sleep patterns predicted smoking initiation. 4 In adults, transitioning from “adequate” to “inadequate” sleep duration over a period of 5 years predicted heavier smoking 5 and preexisting insomnia symptoms increased the likelihood of relapse after an attempt to quit smoking. 6 Chronotype—being a “morning” versus an “evening” person—has also been linked to smoking such that smokers are more likely to be an evening person.…”