Cigarette smoking and alcohol use as predictors of disability retirement: A population-based cohort study. (1st October 2015)

• Record Type: Journal Article
• Authors: Korhonen, Tellervo; Smeds, Eero; Silventoinen, Karri; Heikkilä, Kauko; Kaprio, Jaakko
• Is Part Of: Drug and alcohol dependence. Volume 155(2015)
• Page Start: 260
• Page End: 266
• Publication Date: 2015-10-01
• Subjects: Smoking -- Alcohol -- Disability -- Pension; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2015.06.047
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Cigarette smoking and excess alcohol pose risk for disability retirement. Co-morbid long-term smoking and binge drinking have excess retirement risk. To extend work careers, more attention should be paid to substance use and abuse. Abstract: Background: This study investigated how cigarette smoking and alcohol use predict disability retirement. Methods: Data from the longitudinal nationwide Finnish Twin Cohort study were analyzed, with clustered study design applied when computing 95% confidence intervals (CI). The sample included 21, 719 individuals. Smoking and alcohol use were assessed with a questionnaire in 1975. Registry data on retirement events up till end of 2004 were obtained from the Social Insurance Institution and the Finnish Centre for Pensions. Results: Disability pension was granted to 4251 participants. Among men, adjusted for age and alcohol use, former (HR = 1.45, 95%CI 1.28, 1.65, p < .001) and daily smokers (HR = 1.93, 95%CI 1.71, 2.17, p < .001) showed elevated disability pension risk compared to never smokers. Among women, daily smokers (HR = 1.25, 95%CI 1.11, 1.40, <.001) had elevated risk. The age and smoking adjusted risk estimates for alcohol were elevated among abstainers (men HR = 1.41, 95%CI 1.21, 1.65, p < .001; women HR = 1.36, 95%CI 1.23, 1.52, p < .001) and heavy drinkers (men HR = 1.30, 95%CI 1.18, 1.43, p < .001; women HR = 1.34, 95%CI 1.04, 1.72, p = .026). Those being persistent smokers and binge drinkers had over three-fold disability risk compared to those who were binge drinkers but had only a few smoking years (men: HR = 3.32, 95%CI 2.43, 4.54, p < .001; women: HR = 4.05, 95%CI 2.05, 8.00, p < .001). Among men and women who were not binge drinkers, longer smoking duration was needed for elevated disability risk. Conclusions: Both smoking and excess alcohol use significantly predict disability retirement. In order to extend working careers, more attention should be paid to health behaviors, in addition to working conditions.