Associations of sustained smoking and smoking cessation with work-related outcomes: a longitudinal analysis
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ORIGINAL ARTICLE
Associations of sustained smoking and smoking cessation with work‑related outcomes: a longitudinal analysis Sigrid A. Troelstra1,2 · Cécile R. L. Boot1 · Janneke Harting2 · Goedele A. Geuskens3 · Anton E. Kunst2 · Allard J. van der Beek1 Received: 13 May 2019 / Accepted: 20 October 2020 © The Author(s) 2020
Abstract Purpose The aim of this study was to assess the association between sustained smoking and quitting with work-related outcomes among older workers. Methods We categorized a sample of older employees into non-smokers, sustained smokers and quitters. Multivariable regression models were used to test longitudinal associations of sustained smoking and smoking cessation with sickness absence, productivity loss and work ability. Results We included 3612 non-smokers, 673 sustained smokers and 246 quitters. Comparing sustained smokers to nonsmokers, we found higher (but not statistically significant) sickness absence for sustained smokers [1.01, 95% confidence interval (CI) − 0.16–2.17]. We did not find differences in productivity loss (OR 0.82, 95% CI 0.60–1.13) and work ability (0.05, 95% CI −0.05–0.15). For employees with a relatively high physical health at baseline, comparing quitters to sustained smokers, we found higher (but not statistically significant) productivity loss for quitters (OR 2.23, 95% CI 0.94–5.31), and no difference in sickness absence (0.10, 95% CI − 2.67–2.87), and work ability (− 0.10, 95% CI − 0.36–0.16). For employees with a relatively low physical health at baseline, comparing quitters to sustained smokers, we found a statistically significant lower work ability (− 0.31, 95% CI − 0.57–0.05), and no difference in sickness absence (2.53, 95% CI − 1.29–6.34) and productivity loss (OR 1.26, 95% CI 0.66–2.39). Conclusions We found no evidence that sustained smokers have less favorable work-related outcomes than non-smokers or that quitters have more favorable work-related outcomes than sustained smokers. The benefits of smoking cessation for employers might take a longer time to develop. Keywords Smoking · Smoking cessation · Sickness absence · Work productivity · Work ability · Older workers
Background
* Cécile R. L. Boot [email protected] 1
Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University, Van der Boechorstraat 7, 1081 BT Amsterdam, The Netherlands
2
Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
3
Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
Smoking remains a major worldwide public health threat (World Health Organization 2018). Next to an increased risk of premature death, smokers experience more health problems compared to non-smokers. Smokers have an increased risk of developing cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and various types of cancer (Kõks et al. 2018; Taghizadeh et al. 2016). Furthermore,
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