Article Text

Download PDFPDF
Effect of smoking on use of antibacterials: a 9-year follow-up study of 24 000 working-aged Finns
  1. Karoliina Koskenvuo1,2,
  2. Antti Huunan-Seppälä3,
  3. Timo Keistinen4,
  4. Ilona Autti-Rämö1,
  5. Lauri A Laitinen5,
  6. Markku Koskenvuo2
  1. 1Social Insurance Institution of Finland, Research Department, Helsinki, Finland
  2. 2Department of Public Health, University of Helsinki, Helsinki, Finland
  3. 3Department of General Practice, University of Tampere, Tampere, Finland
  4. 4Ministry of Social Affairs and Health, Helsinki, Finland
  5. 5Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland
  1. Correspondence to Dr Karoliina Koskenvuo, Social Insurance Institution of Finland, Research Department, PO Box 450, Helsinki 00101, Finland; karoliina.koskenvuo{at}


Background Previous studies indicate an association between tobacco smoking and infectious diseases. However, large population-based follow-up studies including both accurate measurements of smoking behaviour and confounders and a reliable register-based follow-up of infections are lacking.

Objective To examine the effect of smoking on use of antibacterials as an indicator of infections among working-aged population.

Methods The participants of the population-based Health and Social Support Study (24 283 working-aged Finns) were followed up for 9 years. Information on smoking behaviour and confounders was obtained from a questionnaire in 1998. Number of antibacterial purchases was obtained from the National-Drug-Prescription-Register. The association between smoking and use of antibacterials was analysed using multinomial regression models.

Results A graded association between lifetime smoking as measured by pack-years and use of antibacterials was found. Compared with never-smokers, the age-adjusted OR for multiple use of antibacterials among smokers with 12 or more pack-years was 2.32 (95% CI 1.91 to 2.82) in women and 1.45 (95% CI 1.23 to 1.71) in men. The associations remained after adjustment for the following confounding factors: use of alcohol, body mass index, physical activity, socioeconomic status, hard physical work, life satisfaction, disability pension and dyspnoea.

Conclusions Smoking is associated with increased use of antibacterials. Infectious periods experienced by patients should be used as an opportunity to encourage smoking cessation.

  • Use of antibacterials
  • smoking behaviour
  • population-based follow-up
  • health services
  • smoking-caused disease
  • primary healthcare

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding The postal survey in 1998 was funded by the Academy of Finland (MK). The study sponsor had no role in the study design, the collection, analysis or interpretation of the data, the writing of the report or the decision to submit the paper for publication.

  • Correction notice This article has been corrected since it was published Online First. The affiliations for the authors have been updated.

  • Competing interests All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare that they have no relationships with any company that might have an interest in the submitted work in the previous 3 years nor do their spouses, partners or children have any financial relationships that may be relevant to the submitted work, and they have no non-financial interests that may be relevant to the submitted work.

  • Patient consent Population data includes only the questionnaire file and register data.

  • Ethics approval The ethical committee of the University of Turku (Turku, Finland) has approved the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data of this study include information on use of medications (from the National-Drug-Prescription-Register data), and we are not allowed to share that information. Thus, unfortunately the unpublished data from this study are not available.