Employment characteristics and tobacco product use, United States, 2021

Am J Prev Med. 2024 May 8:S0749-3797(24)00141-7. doi: 10.1016/j.amepre.2024.05.001. Online ahead of print.

Abstract

Introduction: Over 30 million U.S. working adults use tobacco, and tobacco use varies by occupation. Limited information is available on employment characteristics and tobacco use prevalence. The purpose of this study was to describe the prevalence of current tobacco use by employment characteristics and occupation group among U.S. working adults.

Methods: This cross-sectional study used 2021 National Health Interview Survey data for currently working adults (n=16,461) analyzed in 2023. Multivariable logistic regression was used to estimate adjusted odds of tobacco use by employment characteristics and occupation group.

Results: In 2021, 20.0% of working adults used tobacco. Any tobacco use was significantly lower among workers who were offered workplace health insurance (aOR=0.86, 95% CI=0.77-0.97), had paid sick leave (aOR=0.81, 95% CI=0.73-0.91), and government vs. private employment (aOR=0.61, 95% CI=0.52-0.70). Any tobacco use was significantly higher among workers who usually worked ≥35 hours per week vs. did not usually work ≥35 hours per week (aOR=1.21, 95% CI=1.06-1.39), worked a rotating or 'some other' shift vs. daytime shift (aOR=1.19, 95% CI=1.02-1.38), experienced schedule instability (aOR=1.17, 95% CI=1.03-1.31), and worked while physically ill in the past 3 months (aOR=1.25, 95% CI=1.11-1.41). Tobacco use by employment characteristics also varied by occupation group.

Conclusions: Current tobacco use varied according to employment characteristics and occupation group. Findings from this study could inform workplace tobacco cessation interventions and policies (e.g., access to paid sick leave or insurance coverage) to better support tobacco cessation and overall worker health.

Keywords: NHIS; cessation; employment; occupation; tobacco; working.