Job-related stress and tobacco smoking: A systematic review

Abstract Job-related stress may affect smoking initiation, progression, and intensity, therefore, it is important to have a better understanding of these associations to design targeted and effective workplace cessation programs. In this study, we aimed to synthesize existing literature concerning the relationship between job-related stress and tobacco use among adult workers (18 years and older). We searched articles indexed in six major databases (Scopus, PubMed, Embase, Web of Science, EBSCO, and Ovid) between 1997 and March 2020. We included cross-sectional and cohort studies published in English that examined self-reported smoking status or change in smoking status as exposure variables, and job-related status as the outcome variable consistent with the Demand Control Support and Effort-Reward Imbalance models. We searched the databases using combinations of keywords including “occupational stress,” or “job stress” or “work stress” or “job strain” and “smoking” or “tobacco use” or “tobacco consumption” or “cigarettes.” Of 906 identified articles, 19 (n = 240,787 participants) were included in this review. Findings showed no clear association between job-related stress and smoking status (smoking vs nonsmoking) and smoking cessation. However, the findings suggest an association between job-related stress and changing smoking habits, toward heavier smoking. Our findings indicate that job-related stress may lead to increased smoking intensity.