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Understanding the Association Between Substance Use and Loneliness in Midlife and Older Adults
Hermine Poghosyan1, Jennifer McIntosh1, Sayantani Sarkar2
1Yale School of Nursing, Yale University, 400 West Campus Drive, Orange, CT 06477, USA.
International Journal of Environmental Research and Public Health
|February 27, 2026
Summary
Substance use, including binge alcohol and e-cigarettes, is linked to increased loneliness in adults over 50. This public health issue highlights the need for interventions addressing both substance use and social isolation in older populations.
Area of Science:
- Gerontology
- Public Health
- Substance Abuse Research
Background:
- Substance use is a growing public health concern with potential links to social isolation.
- Loneliness affects many adults, particularly older populations, impacting overall well-being.
Purpose of the Study:
- To examine the association between substance use (binge alcohol, e-cigarettes, traditional cigarettes) and loneliness.
- To investigate this relationship in adults aged 50 years and older in the United States.
Main Methods:
- Secondary analysis of cross-sectional data from the 2023 Behavioral Risk Factor Surveillance System.
- Included 138,614 adults aged ≥50 years, representing ~55.4 million individuals.
- Substance use categorized as current use of ≥1 of three substances versus no substance use.
Main Results:
- 19.0% of participants reported using at least one substance.
- Adults using ≥1 substance showed a 17.0% higher relative risk of feeling lonely always/usually compared to non-users (RRR 1.17; p=0.029).
- Significant association found between substance use and persistent loneliness in older adults.
Conclusions:
- Substance use is strongly associated with increased feelings of loneliness among midlife and older adults.
- Findings highlight the interconnectedness of substance use and social isolation in this demographic.
- Underscores the need for integrated public health strategies addressing both issues.
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