ArticleThe Lancet regional health. Europe2022
Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England.
Article in The Lancet regional health. Europe, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Association between life satisfaction and health behaviours among older adults: a systematic review and meta-analysis.The international journal of behavioral nutrition and physical activity · 2026Pooled it
- Prevalence of stress and associated factors among students in Ethiopia: a systematic review and meta-analysis.Frontiers in public health · 2025Pooled it
- Strategies to deliver smoking cessation interventions during targeted lung health screening - a systematic review and meta-analysis.Chronic respiratory diseasePooled it
- The dynamic interplay between loneliness and health behaviors from adolescence to midlife: A Norwegian population-based cohort study.Psychological medicine · 2026Article
- Prevalence of loneliness and its associated factors in middle-aged and older adults with breathlessness: a nationally representative cohort study.BMJ open respiratory research · 2026Article
- Stigma toward female smokers: gendered perceptions and moral judgment.BMC psychology · 2026Article
- Understanding Gender Gaps in Tobacco Consumption among Middle-Aged and Elderly Indians: Decomposition Analysis of LASI 2017-18.Journal of epidemiology and global health · 2026Article
- Sex Differences in Cigarette Smoking Among Hispanic and Non-Hispanic Black All of Us Participants: The Relative Importance of Sociodemographic Characteristics and Social Determinants of Health.Journal of racial and ethnic health disparities · 2026Article
- Identification of genetic associations and key influences contributing to the pathway from social isolation or loneliness to depression.European archives of psychiatry and clinical neuroscience · 2026Article
- Social connections are differentially related to subjective age and physiological age acceleration amongst older adults.Nature communications · 2026Article
- Relationship of breathlessness with social isolation and loneliness: a nationally representative cohort study of older adults in England.BMJ public health · 2026Article
- Longitudinal Examination of Loneliness and Smoking in Adolescents and Young Adults: A Multiple Dataset Study.International journal of mental health and addiction · 2026Article
- Prevalence and determinants of tobacco use among university students in Lebanon: Implications for smoke-free campus policies.PloS one · 2026Article
- Loneliness and smoking status: a pilot study of extended-stay hotel residents in Atlanta, Georgia.Frontiers in public health · 2026Article
- Social isolation and lung function in middle-aged and older adults: identifying modifiable pathways across two populations.BMC public health · 2025Article
- Association between activities of daily living and depression symptoms among older adults in China: A nationally representative cross-sectional survey.BMC psychology · 2025Article
- Smoking cessation behavior, nicotine addiction, and mental health among current smokers in Klang Valley, Malaysia- a cross-sectional questionnaire survey.BMC public health · 2025Article
- Rethinking Smoking and Quitting in Low-Income Contexts: A Qualitative Analysis with Implications for Practice and Policy.International journal of environmental research and public health · 2025Article
- Long-term elevated levels of loneliness are linked to lower health-related quality of life in middle-aged Australian women.Communications psychology · 2025Article
- Smoking status and voting behaviour and intentions in countries of the former Soviet Union.Scientific reports · 2025Article
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Abstract
backgroundSmoking 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.
methodsIn 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.
findingsAt 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. No association was found between smoking and changes in cohabitation status. Findings were independent of all identified confounders, including age, sex, social class and the presence of physical and mental health diagnoses.
interpretationSmoking is associated with the development of increasing social isolation and loneliness in older adults, suggesting smoking is detrimental to aspects of psychosocial health. The idea that smoking might be prosocial appears a misconception.
fundingUK Economic and Social Research Council & Imperial College London.
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