The role of alcohol use and cigarette smoking in sickness absence: Are there social inequalities?

Abstract

BACKGROUND\nWhile studies have found a social gradient in negative consequences of drinking and smoking, evidence is less clear for a gradient also in alcohol use and smoking s association with sickness absence. We investigate the association between alcohol use and cigarette smoking and general sickness absence, and examine the moderating role of socio-economic status for these associations when controlling for general health status.\n\n\nMETHOD\nQuestions on alcohol use, measured by the Alcohol Use Disorders Identification Test (AUDIT-C), smoking, general health and sickness absence were included in annual national cross-sectional telephone surveys on alcohol, tobacco and drug use (2015-18) amongst Norwegian adults aged 16-79-years (average response rate=59%). The analytic sample comprised 4719 full- and part-time employees aged 25-79 years (46.7% were female, mean age=44.3 years). Individual-level data on education were obtained from national registries.\n\n\nRESULTS\nIn adjusted negative binomial regression analyses, current and former daily smoking were associated with a higher occurrence of sickness absence in groups with low educational attainment, but not in groups with high educational attainment. Alcohol use was negatively associated with sickness absence. While a significantly higher number of sickness days was reported by smokers in the low compared with the high education group, educational attainment did not moderate the alcohol use - sickness absence association.\n\n\nCONCLUSION\nDaily smoking is associated with sickness absence. A negative social gradient was found in the smoking - absence association. Reduced daily smoking might give a reduction in sickness absence.