Tobacco use: selection, stress, or culture?

The effects of selection, job stress, and culture models on the association between occupation and smoking were empirically estimated on a random sample of 2,362 employed adults in Orange County, California using data collected through the Orange County Health Survey. The largest percent of smokers were blue-collar workers (32.4%). The logistic regression analysis results indicated that age, sex, education, ethnicity, job stress, and the industry in which employees work had significant impact on the risk of smoking. The findings imply that all three models contribute to smoking behavior. Smoking cessation and prevention programs may include elements that address both stress and environment in intervention design. Stress models imply that such program should focus on change in individual coping mechanisms; social environment models imply that change in group norms and attitudes is necessary.