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The effect of smoking cessation on work disability risk: a longitudinal study analysing observational data as non-randomized nested pseudo-trials
Univ Helsinki, Dept Psychol & Logoped, Med, Haartmaninkatu 3,PL 21, FIN-00014 Helsinki, Finland; Finnish Inst Occupat Hlth, Dept Occupat Hlth, Helsinki, Finland.
Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland.
Clinicum, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland.
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2019 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 48, no 2, p. 415-422Article in journal (Refereed) Published
Abstract [en]

Background

Smoking increases disability risk, but the extent to which smoking cessation reduces the risk of work disability is unclear. We used non-randomized nested pseudo-trials to estimate the benefits of smoking cessation for preventing work disability.

Methods

We analysed longitudinal data on smoking status and work disability [long-term sickness absence (≥90 days) or disability pension] from two independent prospective cohort studies—the Finnish Public Sector study (FPS) (n = 7393) and the Health and Social Support study (HeSSup) (n = 2701)—as ‘nested pseudo-trials’. All the 10 094 participants were smokers at Time 1 and free of long-term work disability at Time 2. We compared the work disability risk after Time 2 of the participants who smoked at Time 1 and Time 2 with that of those who quit smoking between these times.

Results

Of the participants in pseudo-trials, 2964 quit smoking between Times 1 and 2. During the mean follow-up of 4.8 to 8.6 years after Time 2, there were 2197 incident cases of work disability across the trials. Quitting smoking was associated with a reduced risk of any work disability [summary hazard ratio = 0.89, 95% confidence interval (CI) 0.81–0.98]. The hazard ratio for the association between quitting smoking and permanent disability pension (928 cases) was of similar magnitude, but less precisely estimated (0.91, 95% CI 0.81–1.02). Among the participants with high scores on the work disability risk score (top third), smoking cessation reduced the risk of disability pension by three percentage points. Among those with a low risk score (bottom third), smoking cessation reduced the risk by half a percentage point.

Conclusions

Our results suggest an approximately 10% hazard reduction of work disability as a result of quitting smoking.

Place, publisher, year, edition, pages
2019. Vol. 48, no 2, p. 415-422
National Category
Occupational Health and Environmental Health
Identifiers
URN: urn:nbn:se:uu:diva-390154DOI: 10.1093/ije/dyz020ISI: 000479285400019PubMedID: 30815682OAI: oai:DiVA.org:uu-390154DiVA, id: diva2:1340631
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NordForskAvailable from: 2019-08-06 Created: 2019-08-06 Last updated: 2019-09-30Bibliographically approved

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