Productivity Goes Down in Smoke
By Neil Osterweil, Senior Associate Editor, MedPage Today
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.
March 29, 2007
Add Your Knowledge™ Additional Smoking Coverage
SAN DIEGO, March 29 -- From women in the United States Navy to workers throughout Sweden, smoking takes a toll on productivity as well as on health, reported investigators on two continents today. Action Points
Explain to patients who ask that these studies show that cigarette smokers are less productive and take more sick days than their non-smoking co-workers.
Point out that these studies cannot determine whether the act of smoking produces these effects or less productive workers with more sick days are more likely to be smokers.
Among the approximately 59,000 women serving in the U.S. Navy, smoking at the time of enlistment was consistently associated with poor work performance, as well as a higher risk for demotion, desertion, or a less-than-honorable discharge, reported Terry L. Conway Ph.D., and colleagues at San Diego State University Graduate School of Public Health.
And in a study of Swedish workers, Petter Lundborg, Ph.D., an economist at the Free University of Amsterdam in the Netherlands, reported that smokers take an average of nearly eight more sick days annually than their non-smoking co-workers, even after adjusting for health status and for riskier occupations that seem to attract smokers.
Both studies were reported in the April issue of Tobacco Control, a BMJ specialty journal.
"In both the civilian and military sectors, smoking has been linked to disability and job-related outcomes, including decreased productivity, increased absenteeism, and long and more frequent work breaks," Dr. Conway and colleagues wrote. "Tobacco use is of particular concern to the U.S. Department of Defense because, historically, the military has had higher and heavier rates of tobacco use than civilians."
Smoking in the military took a nosedive in the 1980s and stayed down through the mid 1990s, but recovered sharply from 1998 to 2002. In 2002, 33.8% of military personnel reported smoking cigarettes at least once in the past month, the investigators noted.
To see whether tobacco use before joining the navy could predict a poor or lackluster naval career for women, the authors looked at a cohort of 5,487 women who signed up over a one-year period beginning in March 1996.
They used navy attrition-retention and career performance measures to gauge success, looking at factors such as time in service, early attrition, type of discharge, misconduct, number of promotions, demotions, unauthorized absences, highest pay-grade achieved, and re-enlistment.
"Compared with never-smokers, daily smokers at entry into the U.S. Navy had subsequent career outcomes consistently indicating poorer job performance (e.g., early attrition prior to serving a full-term enlistment, more likely to have a less-than-honorable discharge, more demotions and desertions, lower achieved pay-grade and less likely to re-enlist)," they wrote.
There also appeared to be a dose-dependent effect of smoking, with women who smoked a few times a week or only occasionally consistently falling between the daily smokers and never smokers.
For example: 5% of never-smokers quit or were dismissed (in military parlance, "attrited") during recruit training, compared with 6.5% of the sometimes smokers, and 9.5% of daily smokers. Similarly, 6.8% of never-smokers were discharged for misconduct, compared with 8.4% of sometime smokers, and 15.6% of daily smokers.
"Cigarette smoking might simply be a 'marker' for other underlying factors (e.g., non-conformity, high risk-taking) that contribute to poorer performance in the military," the investigators wrote.
In the second study Dr. Lundborg looked at a nationally representative sample of 14,272 Swedish workers to see whether smoking might be associated with absenteeism. The data, from a survey of living conditions in Sweden, were linked to a social insurance database contain information about employee sick days.
The author looked at sick days as a function of smoking status, controlling for occupational risk factors, work characteristics and health status.
He found that smoking increased the average annual number of sick days taken by 10.7 -- 42% of all sick days taken -- compared with never smoking. Former smokers took an average of 3.09 more sick days than never smokers.
Because studies have shown that smokers tend to be risk-takers and are therefore more inclined to choose riskier professions, he controlled for risk factors at work, and found that the effect of smoking reduced sick days taken by one day, to 9.67 days for current smokers. Former smokers needed 2.52 more sick days than never smokers in the adjusted analysis.
作者:admin@医学,生命科学 2010-12-27 17:14