Examining Associations Between Smoking Patterns and Employment Status Among a Nationally Representative Sample of...

Smoking is a leading preventable cause of death, with higher prevalence in certain occupations. Given the evolved work environment after COVID-19 and shifting tobacco use patterns, this study examines recent data to assess the associations between smoking status, employment status, and industry.

The authors analyzed data from the 2023 National Health Interview Survey. Participants were aged ≥18 years, and their employment status was classified as employed or unemployed on the basis of the prior week's work; smoking status was classified as current, former, or never. The prevalence of employment and smoking was calculated. Weighted multinomial logistic regression was used to assess the associations between smoking status, employment status, and industry.

Among the 26,442 adults (50.8% male, 63.6% non-Hispanic Whites, mean age of 49.3 years, 69.7% employed), 11.0% were current smokers, 23.4% were former smokers, and 65.6% were never smokers. Current smoking was highest in wholesale trade (20.5%), information (16.9%), and mining (15.9%) industries. After adjustment, unemployed individuals, particularly those unable to work owing to health reasons, had 93% higher odds of being current smokers (AOR=1.93; 95% CI=1.64, 2.28) and 35% higher odds of being former smokers (AOR=1.35; 95% CI=1.16, 1.58) than those who were employed.

This study highlights the current relationship between employment status, industry, and smoking behaviors in the U.S. Current smoking rates were highest in specific industries, underscoring the need for targeted interventions in these occupational settings. Tailored smoking cessation programs for high-risk industries and unemployed individuals, particularly those unable to work owing to health issues, are crucial. Public health policies should address the unique needs of both employed and unemployed populations to reduce smoking-related health disparities.