In Post-'Mad Men' World, Smoking Is Blue Collar Habit

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Workers in blue- and pink-collar jobs are far more likely to smoke cigarettes than those in white-collar occupations, CDC researchers said.

Data from the National Health Interview Survey (NHIS) from 2004 to 2010 showed that people working in mining, manufacturing, construction, warehousing, and transportation had age-adjusted smoking prevalence rates far above the 19.6 percent national average.

Incredibly, 30 percent of mining industry workers -- many of whom are already at risk for respiratory diseases because of their occupational exposures -- reported that they were current smokers, according to a report in the Sept. 30 issue of Morbidity and Mortality Weekly Report.

At the other end, smoking prevalence was below 15 percent for those who work in education, banking, science, and several other white-collar fields.

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The authors, led by Girija Syamlal of the CDC's National Center for Chronic Disease Prevention and Health Promotion, said employers should do more to reduce smoking in the workforce.

"Employers need to integrate comprehensive and effective smoking cessation programs with other worksite programs including health promotion programs in their workplace," they wrote.

The CDC researchers pulled data from the NHIS, an annual survey of a representative sample of U.S. adults regarding health status and behaviors. The data include respondents' occupations in 23 categories and which of 21 industry groups they work in.

Current smokers were those indicating that they had smoked at least 100 cigarettes in their lifetimes and who said they currently smoked every day or some days.

Among industry groups, prevalences were at or near 30 percent for people employed in mining, construction, and the hospitality sector. The lowest prevalences were in education services (9.7 percent), corporate management (10.9 percent), and finance and insurance (13.9 percent).

Data for individual occupations divided along similar lines. The highest prevalences were in construction and extraction (31.4 percent), food preparation and serving (30.0 percent), and transportation and material moving (28.7 percent).

Education, training, and library work had the lowest prevalence (8.7 percent), followed by science (9.2 percent) and law-related jobs (9.4 percent).

The healthcare industry epitomized the collar-color divide. Across the entire sector of healthcare and social assistance, smoking prevalence among all employees was 15.9 percent.

But the analysis had two occupational categories for workers in health-related jobs: healthcare support and healthcare practitioners and technical. Smoking prevalence was 23.7 percent in the support category, double the 11.8 percent rate seen in the latter group.

Syamlal and colleagues did not report multivariate analyses, but their data suggested that education level went hand in hand with occupation in smoking prevalence.

Individuals with a bachelor's degree or more had a smoking prevalence rate of 9.1 percent. Among those with "some" college the rate was 21 percent, whereas it was 28.4 percent for those who did not get past high school.

Occupations typically requiring four-year college degrees -- law, science, teaching, architecture and engineering, information technology -- all had smoking prevalence rates below 14 percent.

Other worker characteristics related to smoking prevalences included poverty status, race/ethnicity, gender, age, and health insurance status.

Being poor or near-poor, uninsured, white, young, and male were each associated with higher smoking rates.

Syamlal and colleagues noted that overall smoking prevalence found in the study was well short of the Healthy People 2010 goal of 12 percent or less.

They recommended several steps that employers can take to reduce smoking among their workers, which could help them reduce absenteeism and healthcare costs. These included:

Covering tobacco-dependence treatments in employer-sponsored health plans

Establishing smoke-free workplaces

Educating employees who smoke about the value of quitting and the availability of support programs

Partnering with state and local health departments to implement policies and programs