Background
Smoking is often colloquially considered “social”. However, the actual relationship of smoking with current and future social isolation and loneliness is unclear. We therefore examined these relationships over a 12-year follow-up. Methods
In this cohort study, we used a nationally representative sample of community dwelling adults aged 50 years and over from the English Longitudinal Study of Ageing (N=8780) (45% male, mean(SD) age 67(10) years. We examined associations of self-reported smoking status at baseline assessment, with social isolation (low social contact, social disengagement, domestic isolation), and loneliness (3-item UCLA loneliness scale), measured at baseline, and follow-up at 4, 8 and 12 years, using ordinary least squares regression models.
Findings
At baseline, smokers were more likely to be lonely (coef.=0·111, 95% CI 0·025 – 0·196) and socially isolated than non-smokers, having less frequent social interactions with family and friends (coef.= 0·297, 95%CI 0·148 – 0·446), less frequent engagement with community and cultural activities (coef.= 0·534, 95%CI 0·421 – 0·654), and being more likely to live alone (Odds Ratio =1·400, 95%CI 1·209 – 1·618). Smoking at baseline was associated with larger reductions in social contact (coef.=0·205, 95%CI 0·053 – 0·356, to 0·297, 95%CI 0·140 – 0·455), increases in social disengagement (coef.=0·168, 95%CI 0·066 – 0·270, to coef.=0·197, 95%CI 0·087 – 0·307), and increases in loneliness (coef.=0·105, 95%CI 0·003 – 0·207), at 4-year follow-up) over time.
Who could have guessed that a concerted, state-led campaign of ostracism and demonisation in which the law was used to drive smokers out of all indoor venues and a large number of outdoor venues would have led to the outgroup being socially isolated? I for one am stunned.
These findings have important policy implications. Firstly, they further strengthen the justification for anti-smoking legislation
Adding to other research on the health impacts of smoking, our results suggest that smoking is potentially detrimental to aspects of psychosocial health.
Although causality cannot be assumed, and further research is warranted, the idea held by some that smoking might be prosocial appears to be a misconception, with serious implications for health and wellbeing throughout the lifespan.
As I have said before, 'public health' activists are the kind of people who would put a brick through your window and then try to sell you double glazing. For years they have shed crocodile tears over tobacco sales leading to secondary poverty, as if it were not the direct result of the exorbitant taxation they campaigned for. Now they are claiming, in effect, that smoking causes loneliness.
These findings emphasise the intersection of two major public health priorities which requires further attention. In policy terms it provides a further basis to increase efforts to achieve Smokefree society.
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