Description
Objective: To determine the association between cigarette smoking behavior and employment status among U.S. adults in the job market. Methods: Data from participants of the National Survey on Drug Use and Health were analyzed. We performed bivariate and multivariate analyses to determine whether a higher prevalence of smoking was associated with different levels of employment among survey participants. The final analysis controlled for gender, age, ethnicity, education, income, substance use, such as alcohol, marijuana and cocaine, as well as a stress indicator. Results: Those self-reported as unemployed were 1.1, 1.3, 1.2 and 1.3 times more likely to have smoked in the past month when compared to individuals employed full time for 2008, 2009, 2010 and 2011 respectively (95% CIs [0.9 — 1.5], [1.0 — 1.6], [1.0 — 1.6] [1.1 1.7] for 2008 — 2011 respectively). Those self-reported as employed part-time were less likely to have smoked in the past month when compared to full-time employees. Age, ethnicity, education and income were significantly associated with past-month cigarette use among subjects. Lastly, past-month substance use, such as alcohol, marijuana and cocaine, were also significantly associated with smoking. Men had a higher rate of self-reported smoking when compared to women, consistent across all four years (29.5% v. 25.3% in 2008, 29.9% v. 24.9% in 2009, 28.8% v. 23.6% in 2010 and 26.8% v. 22.7% in 2011). Discussion: Past-month cigarette use among U.S. adults over 18 years of age may be associated with employment status. This association provides the opportunity for the development of more robust smoking prevention and cessation interventions. As technological advances move the health intervention in the individual's home, through using patient portals and electronic health records, interventionists can now target these individuals with increased selection accuracy and precision, reaching a wider audience faster and easier. Although two significant relationships were identified between smoking behavior and employment status, this result, coupled with an inconsistent trend across the four survey years, indicates a weak association that does not currently make a strong case for real, clinically relevant relationships between current smoking status and employment levels. Further research should attempt to identify additional variability that may be hidden behind the unemployed / part-time employed label, such as household or peer smoking, time spent at home while looking for work and other social and environmental determinants of smoking.
