Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Heikkila K

PROVIDER: S-EPMC3391192 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Publications

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

Heikkilä Katriina K Nyberg Solja T ST Fransson Eleonor I EI Alfredsson Lars L De Bacquer Dirk D Bjorner Jakob B JB Bonenfant Sébastien S Borritz Marianne M Burr Hermann H Clays Els E Casini Annalisa A Dragano Nico N Erbel Raimund R Geuskens Goedele A GA Goldberg Marcel M Hooftman Wendela E WE Houtman Irene L IL Joensuu Matti M Jöckel Karl-Heinz KH Kittel France F Knutsson Anders A Koskenvuo Markku M Koskinen Aki A Kouvonen Anne A Leineweber Constanze C Lunau Thorsten T Madsen Ida E H IE Magnusson Hanson Linda L LL Marmot Michael G MG Nielsen Martin L ML Nordin Maria M Pentti Jaana J Salo Paula P Rugulies Reiner R Steptoe Andrew A Siegrist Johannes J Suominen Sakari S Vahtera Jussi J Virtanen Marianna M Väänänen Ari A Westerholm Peter P Westerlund Hugo H Zins Marie M Theorell Töres T Hamer Mark M Ferrie Jane E JE Singh-Manoux Archana A Batty G David GD Kivimäki Mika M

PloS one 20120706 7

<h4>Background</h4>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.<h4>Methodology and principal findings</h4>We analysed cross-sectional data from 15 European studies comprising 166,130 pa ...[more]

PMID: 22792154

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Project description:AimsTo investigate cross-sectional and longitudinal associations between personality and smoking, and test whether socio-demographic factors modify these associations.DesignCross-sectional and longitudinal individual-participant meta-analysis.SettingNine cohort studies from Australia, Germany, the United Kingdom and the United States.ParticipantsA total of 79 757 men and women (mean age = 50.8 years).MeasurementsPersonality traits of the five-factor model (extraversion, neuroticism, agreeableness, conscientiousness and openness to experience) were used as exposures. Outcomes were current smoking status (current smoker, ex-smoker and never smoker), smoking initiation, smoking relapse and smoking cessation. Associations between personality and smoking were modelled using logistic and multinomial logistic regression, and study-specific findings were combined using random-effect meta-analysis.FindingsCurrent smoking was associated with higher extraversion [odds ratio per 1 standard deviation increase in the score: 1.16; 95% confidence interval (CI) = 1.08-1.24], higher neuroticism (1.19; 95% CI = 1.13-1.26) and lower conscientiousness (95% CI = 0.88; 0.83-0.94). Among non-smokers, smoking initiation during the follow-up period was predicted prospectively by higher extraversion (1.22; 95% CI = 1.04-1.43) and lower conscientiousness (0.80; 95% CI = 0.68-0.93), whereas higher neuroticism (1.16; 95% CI = 1.04-1.30) predicted smoking relapse among ex-smokers. Among smokers, smoking cessation was negatively associated with neuroticism (0.91; 95% CI = 0.87-0.96). Socio-demographic variables did not appear to modify the associations between personality and smoking.ConclusionsAdult smokers have higher extraversion, higher neuroticism and lower conscientiousness personality scores than non-smokers. Initiation into smoking is associated positively with higher extraversion and lower conscientiousness, while relapse to smoking among ex-smokers is associated with higher neuroticism.

Project description:BACKGROUND:Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies. METHODS:We used individual records from 13 European cohort studies (1985-2006) of men and women without coronary heart disease who were employed at time of baseline assessment. We measured job strain with questions from validated job-content and demand-control questionnaires. We extracted data in two stages such that acquisition and harmonisation of job strain measure and covariables occurred before linkage to records for coronary heart disease. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. FINDINGS:30,214 (15%) of 197,473 participants reported job strain. In 1·49 million person-years at risk (mean follow-up 7·5 years [SD 1·7]), we recorded 2358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio for job strain versus no job strain was 1·23 (95% CI 1·10-1·37). This effect estimate was higher in published (1·43, 1·15-1·77) than unpublished (1·16, 1·02-1·32) studies. Hazard ratios were likewise raised in analyses addressing reverse causality by exclusion of events of coronary heart disease that occurred in the first 3 years (1·31, 1·15-1·48) and 5 years (1·30, 1·13-1·50) of follow-up. We noted an association between job strain and coronary heart disease for sex, age groups, socioeconomic strata, and region, and after adjustments for socioeconomic status, and lifestyle and conventional risk factors. The population attributable risk for job strain was 3·4%. INTERPRETATION:Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking. FUNDING:Finnish Work Environment Fund, the Academy of Finland, the Swedish Research Council for Working Life and Social Research, the German Social Accident Insurance, the Danish National Research Centre for the Working Environment, the BUPA Foundation, the Ministry of Social Affairs and Employment, the Medical Research Council, the Wellcome Trust, and the US National Institutes of Health.

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Dataset Information

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

Background

Methodology and principal findings

Conclusions

Publications

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

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