Occupational correlates of smoking among urban transit operators: a prospective study.
BACKGROUND
Workers in blue-collar and service occupations smoke at higher rates than workers in white-collar and professional occupations. Occupational stress may explain some of the occupational class differences in smoking and quitting behavior. The purpose of this study is to investigate the contribution of occupational factors to smoking behavior over a ten year period among a multiethnic cohort of urban transit operators, while accounting for demographic factors and alcohol.


METHODS
The sample consists of 654 San Francisco Municipal Railway (MUNI) transit operators who participated in two occupational health studies and biennial medical examinations during 1983-85 and 1993-95. Workers who had initiated, increased, or maintained their smoking over the ten year period were compared to workers who remained non-smokers. Occupational factors included self-rated frequency of job problems (e.g., difficulties with equipment, passengers, traffic), job burnout (i.e., the emotional exhaustion subscale of the Maslach Burnout Inventory), time needed to unwind after work, and years employed as a transit operator. A series of logistic regression models were developed to estimate the contribution of occupational factors to smoking behavior over time.


RESULTS
Approximately 35% of the workers increased, initiated, or maintained their smoking over the ten-year period. Frequency of job problems was significantly associated with likelihood of smoking increase, initiation, or maintenance (OR = 1.30; 95% CI 1.09, 1.55). Black operators were significantly more likely to have smoked over the ten-year period compared to operators in other racial/ethnic groups.


CONCLUSIONS
Understanding the role of work-related stress vis-à-vis smoking behavior is of critical importance for crafting workplace smoking prevention and cessation interventions that are applicable to blue-collar work settings, and for developing policies that mitigate occupational stress.
Cunradi
Carol B
CB
Prevention Research Center, Pacific Institute for Research and Evaluation, 1995 University Avenue, Suite 450, Berkeley, CA 94704, USA. cunradi@prev.org
Lipton
Rob
R
Banerjee
Aniruddha
A
D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D000428:Alcohol Drinking / Q000453:epidemiology / Q000208:ethnology; D000704:Analysis of Variance; D002055:Burnout, Professional / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000208:ethnology; D016272:Occupational Health / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012495:San Francisco / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology; D012923:Social Class; D013997:Time Factors; D014186:Transportation; D014505:Urban Population; D000078329:Workforce