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Occupational Gradients in Smoking Behavior and Exposure to Workplace Environmental Tobacco Smoke: The Multi-Ethnic Study of Atherosclerosis

Fujishiro, Kaori PhD; Stukovsky, Karen D. Hinckley MS; Roux, Ana Diez PhD, MD; Landsbergis, Paul PhD; Burchfiel, Cecil PhD

Journal of Occupational and Environmental Medicine: February 2012 - Volume 54 - Issue 2 - p 136–145
doi: 10.1097/JOM.0b013e318244501e
Original Articles

Objective: This study examines associations of occupation with smoking status, amount smoked among current and former smokers (number of cigarettes per day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education.

Methods: This is a cross-sectional analysis of data from a community sample (n = 6355, age range: 45–84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables.

Results: Male blue-collar and sales/office workers had higher odds of having consumed more than 20 pack-years of cigarettes than managers/professionals. For both male and female current or former smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years.

Conclusions: Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual and workplace levels especially in blue-collar workplaces.

From the National Institute for Occupational Safety and Health, Cincinnati, Ohio (Dr Fujishiro) and Morgantown, WVa (Dr Burchfiel); University of Washington (Ms Stukovsky), Seattle, Wash; University of Michigan (Dr Diez Roux), Ann Arbor, Mich; and State University of New York Downstate Medical Center (Dr Landsbergis), Brooklyn, New York.

Address correspondence to: Kaori Fujishiro, PhD, Division of Surveillance, Hazard Evaluation, and Field Studies, National Institute for Occupational Safety and Health, 4676 Columbia Pkwy (R-15), Cincinnati, OH 45226 (

Disclaimer: The findings and conclusions in this paper are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

Conflict of interest: None declared.

Copyright © 2012 by the American College of Occupational and Environmental Medicine