Candace Nelson (candace_nelson_250)

Home stress, work stress linked with increased smoking

September 12, 2012 — According to new research from Harvard School of Public Health (HSPH), there’s a strong association between work-family conflict and the likelihood of smoking.

Candace Nelson, research fellow in the Department of Environmental HealthLisa Berkman, director of the Harvard Center for Population and Development Studies, and Glorian Sorensen, professor of society, human development, and health and director of the Dana Farber Cancer Institute Center for Community-Based Research, along with Yi Li of the University of Michigan School of Public Health, analyzed data on 452 New England long-term-care facility workers from interviews conducted in 2006 and 2007. They chose to study long-term-care workers because their jobs are physically and emotionally demanding, don’t pay that well, and are likely to be associated with adverse health consequences.

Work-family conflict refers to a situation in which expectations or demands from one of those domains affects the other. The HSPH researchers considered the direction of the conflict—that is, work interfering with family and vice-versa—because previous research has shown that different directions can lead to different outcomes.

Workers who experienced conflict in both directions—that is, both stress at home from work (“work-to-home” conflict) and stress at work from personal issues (“home-to-work” conflict)—were 3.1 times more likely to smoke than those who didn’t experience these two types of conflict, the researchers found.

The researchers also looked at each type of conflict separately. Workers who experienced home-to-work conflict were 2.3 times more likely to smoke. The relationship between smoking and work-to-home conflict was much weaker—workers in that category were only 1.6 more likely to smoke. The authors speculated that the greater home-to-work effect on smoking could be explained by the psychological precedence of personal and family life over work life.

The new findings, published in the September 2012 issue of the American Journal of Public Health, build on previous research that has shown, for example, that work-family conflict is associated with alcohol use and depression.

One limitation of the study, the authors say, is that it used a small sample and doesn’t indicate causality because there is no time component in the design. It could be that work-family conflict leads to smoking, or it could be the other way around, but the study did not include information on which occurred first. The next step, they say, would be to replicate their findings in larger studies that do include a time component, and in studies that measure important aspects of home life that were not measured in this study, such as household smoking bans, communication within the household, and presence of other smokers in the household.

If future studies find similar associations, the authors write, it may suggest “a possibly fruitful area for tobacco intervention and control as well as workplace policies related to reducing work-family conflict.” For example, in addition to workplace interventions aimed at reducing tobacco use, employers could consider ways to reduce work-family conflict by targeting workplace practices and policies such as flexible job schedules, use of phones for personal reasons, and personal time off.

“These are often called ‘family-friendly’ policies,” Nelson said, “but, based on the findings presented in this article, we also contend that these policies contribute to the health of workers.”

–Karen Feldscher