title: Smoking and sickness absence among public health workers.
abstract: BACKGROUND
  As well as causing sickness and death, smoking has high socio-economic costs. The aim of this paper was to examine how closely smoking is associated with sickness absence among healthcare workers.
  
  
  METHODS
  Cases and controls were paired by age, gender and occupation among primary healthcare workers in Tenerife, Canary Islands, Spain. Cases were selected from workers that had been absent from work due to sickness for 1 or more days in an entire year, regardless of the cause. Controls were those workers who were not absent due to sickness over the same period. Tobacco consumption was verified by telephone poll. Matched pairs analysis was performed.
  
  
  RESULTS
  Among the 292 cases, 40% were smokers, compared with 31% of controls [odds ratio (OR)=1.51, 95% confidence intervals (CI)=1.06-2.14]. The association between smoking and sickness absence was stronger in those aged 30-45 years (OR=1.60, 95%CI=1.04-2.44) and among nurses (OR=2.08, 95%CI=1.05-4.14). When the cause of sickness absence was a respiratory disease, no association was found with smoking. However, an association was found with back pain (OR=5, 95%CI=1.45-17.27). Duration of tobacco consumption was higher in cases (a) when only current smokers were considered (P=0.002), and (b) when including the smoking duration of former smokers (P=0.0004).
  
  
  CONCLUSIONS
  Smoking is associated with a higher risk of sickness absence among healthcare workers, particularly due to back pain. This could be used as an incentive to persuade healthcare workers to stop smoking and re-inforce the non-smoking message given to their patients.
authors.affiliation: Unidad de Investigación del Hospital de La Candelaria y Atención Primaria, Ctra. de El Rosario s/n, 38010, Santa Cruz de Tenerife, Canary Islands, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Torres Lana
authors.forename: A
authors.initials: A
authors.lastname: Cabrera de León
authors.forename: M T
authors.initials: MT
authors.lastname: Marco García
authors.forename: A
authors.initials: A
authors.lastname: Aguirre Jaime
mesh_terms: D000041:Absenteeism; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D011634:Public Health; D011637:Public Health Nursing; D018582:Sick Leave / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology; D000078329:Workforce