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Relationship between job strain and smoking cessation: the Finnish Public Sector Study
  1. A Kouvonen1,
  2. J Vahtera2,
  3. A Väänänen2,
  4. R De Vogli3,
  5. T Heponiemi4,
  6. M Elovainio4,
  7. M Virtanen2,
  8. T Oksanen2,
  9. S J Cox1,
  10. J Pentti2,
  11. M Kivimäki2,3
  1. 1
    Institute of Work, Health & Organisations, University of Nottingham, Nottingham, UK
  2. 2
    Finnish Institute of Occupational Health, Helsinki, Finland
  3. 3
    Department of Epidemiology and Public Health, University College London, London, UK
  4. 4
    National Research and Development Centre for Welfare and Health (STAKES), Helsinki, Finland
  1. Dr A Kouvonen, Institute of Work, Health & Organisations, International House, University of Nottingham, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK; anne.kouvonen{at}


Aims: To examine whether job strain (ie, excessive demands combined with low control) is related to smoking cessation.

Methods: Prospective cohort study of 4928 Finnish employees who were baseline smokers. In addition to individual scores, coworker-assessed work unit level scores were calculated. A multilevel logistic regression analysis, with work units at the second level, was performed.

Results: At follow-up, 21% of baseline smokers had quit smoking. After adjustment for sex, age, employer and marital status, elevated odds ratios (ORs) for smoking cessation were found for the lowest vs the highest quartile of work unit level job strain (OR 1.43, 95% CI 1.17 to 1.75) and for the highest vs the lowest quartile of work unit level job control (OR 1.61, 95% CI 1.31 to 1.96). After additional adjustment for health behaviours and trait anxiety, similar results were observed. Further adjustment for socioeconomic position slightly attenuated these associations, but an additional adjustment for individual strain/control had little effect on the results. The association between job strain and smoking cessation was slightly stronger in light than in moderate/heavy smokers. The results for individual job strain and job control were in the same direction as the work unit models, although these relationships became insignificant after adjustment for socioeconomic position. Job demands were not associated with smoking cessation.

Conclusions: Smoking cessation may be less likely in workplaces with high strain and low control. Policies and programs addressing employee job strain and control might also contribute to the effectiveness of smoking cessation interventions.

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  • Competing interests: None declared.

  • Funding: The work presented in this paper was supported by grants from the Academy of Finland (projects 105195, 110451, 117604, 124271 and 124322), the Finnish Work Environment Fund (project 103432) and the participating towns and hospitals.

  • Ethics approval: Ethical approval for the study was obtained from the Ethics Committee of the Finnish Institute of Occupational Health.