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- Title
Smoking and Long-Term Sick Leave in a Japanese Working Population: Findings of the Japan Epidemiology Collaboration on Occupational Health Study.
- Authors
Hori, Ai; Inoue, Yosuke; Kuwahara, Keisuke; Kunugita, Naoki; Akter, Shamima; Nishiura, Chihiro; Kinugawa, Chihiro; Endo, Motoki; Ogasawara, Takayuki; Nagahama, Satsue; Miyamoto, Toshiaki; Tomita, Kentaro; Yamamoto, Makoto; Nakagawa, Tohru; Honda, Toru; Yamamoto, Shuichiro; Okazaki, Hiroko; Imai, Teppei; Nishihara, Akiko; Sasaki, Naoko
- Abstract
<bold>Background: </bold>Few studies have investigated the association between tobacco smoking and sick leave (SL) in Japan.<bold>Methods: </bold>We followed 70 896 workers aged 20-59 years (60 133 males, 10 763 females) between April 2012 and March 2017. A Cox proportional hazards model was used to investigate the associations between smoking (smoking status and intensity) and long-term SL (ie, SL lasting ≥30 consecutive days). Cause-specific analyses were also conducted.<bold>Results: </bold>A total of 1777 people took long-term SL during a follow-up of 307 749 person years. Compared with never-smokers, current smokers were at a higher risk of long-term SL (hazard ratio [HR] = 1.32; 95% confidence interval [CI] = 1.19 to 1.48). Cause-specific analyses revealed that current smoking was associated with a higher risk of SL due to all physical disorders (HR = 1.44, 95% CI = 1.22 to 1.69), cancer (HR = 1.49, 95% CI = 1.10 to 2.01), cardiovascular disease (CVD; HR = 2.16, 95% CI = 1.31 to 3.55), and injuries/external causes (HR = 1.83, 95% CI = 1.31 to 2.58). Former smokers were at a higher risk of SL due to cancer at a borderline significance level (HR = 1.38, 95% CI = 0.99 to 1.92). Low-intensity smoking (ie, 1-10 cigarettes smoked per day) was associated with all-cause SL, SL due to CVD, and SL due to injuries/external causes compared with never-smokers.<bold>Conclusion: </bold>In a large cohort of working-age Japanese, smoking was associated with a greater risk of long-term SL. Greater effort is needed to mitigate disease burden associated with smoking at workplace in Japan.<bold>Implications: </bold>Our study contributes to the literature on the association between smoking and SL in several ways. First, the study was conducted among a Japanese working population. While the association has been extensively studied in Western setting, few attempts have been made elsewhere. Second, cause-specific analyses were undertaken in our study. Third, we paid attention to the effect of low-intensity smoking on SL given that there is growing evidence of an elevated health risk associated with low-intensity smoking.
- Subjects
JAPAN; SICK leave; INDUSTRIAL hygiene; PROPORTIONAL hazards models; CIGARETTE smoke
- Publication
Nicotine & Tobacco Research, 2021, Vol 23, Issue 1, p135
- ISSN
1462-2203
- Publication type
journal article
- DOI
10.1093/ntr/ntz204