Job exposure to the public in relation with alcohol, tobacco and cannabis use: Findings from the CONSTANCES cohort study.

Guillaume Airagnes,Yves Roquelaure,Marie Zins,Cédric Lemogne,Marcel Goldberg,Frédéric Limosin,Nicolas Hoertel,Zila M Sanchez

doi:10.1371/journal.pone.0196330

Abstract

ObjectivesTo examine the associations between job exposure to the public (e.g., customers, guests, users of a public service, patients) and alcohol, tobacco and cannabis use.MethodsFrom the French population-based CONSTANCES cohort, 16,566 men and 17,426 women currently working were included between 2012 and 2016. They reported their exposure to the public (daily versus no daily), and among the daily exposed participants (10,323 men and 13,318 women), the frequency of stressful exposure (often versus rarely). Dependent variables were: chronic alcohol consumption (<1(1), 1-27(1–13), 28-42(14–28), >42(28) drinks per week in men(women)), heavy episodic drinking (never, at most once a month, more than once a month), alcohol use risk with Alcohol Use Disorders Identification Test (mild, dangerous, problematic or dependence), tobacco use (non-smoker, former smoker, 1–9, 10–19, >19 cigarettes per day) and cannabis use (never, not in past year, less than once a month, once a month or more). Logistic regressions provided odds ratios of substance use, stratifying for gender and adjusting for sociodemographic confounders, depression, effort-reward imbalance and perceived health status.ResultsExposed men had higher risks of alcohol (chronic alcohol consumption, heavy episodic drinking and alcohol use risk), tobacco and cannabis use. Exposed women had higher risks of tobacco and cannabis use. In men, stressful exposure was associated with increased risks of heavy episodic drinking, tobacco and cannabis use. In women, stressful exposure was associated with increased risks of chronic alcohol consumption, alcohol use risk, tobacco and cannabis use. All these findings remained significant in multivariable analyses, taking into account sociodemographic variables, depressive symptoms, perceived health status and effort-reward imbalance.ConclusionsInterventions to reduce emotional job demand should systematically integrate assessment and prevention measures of addictive behaviors. Vulnerable workers may be offered more specific interventions to reduce the impact of exposure to the public on their substance use.

Highlights

Addictive behaviors are among the first leading preventable causes of premature death in western countries [1]
Vulnerable workers may be offered more specific interventions to reduce the impact of exposure to the public on their substance use
Since our aim was to search for associations between addictive behaviors and job exposure to the public, we selected the sample of 46,652 participants currently working and responders to the assessments of job exposure to the public

Summary

Introduction

Addictive behaviors are among the first leading preventable causes of premature death in western countries [1]. The burden of addiction is mainly driven by three substances: alcohol, tobacco and cannabis [2]. Consumption of these substances is involved, with a dose-dependent relationship [3], in many somatic disorders (e.g. cardiovascular disorders, cancers, liver disease) [3, 4], psychiatric disorders (e.g. depression, suicide) [5,6,7,8] as well as with social deprivation [9] and detrimental effects on work [10, 11]. Exposure to psychosocial job strain, characterized by high psychological work demand and low decisional latitude to cope with the task, lead to an increased risk of substance use disorders [12], especially concerning alcohol [13, 14], tobacco [15] and cannabis [16]. The associations between substance use disorders and emotional job demand has been less explored [17] athough it might constitute a fruitful avenue to refine preventive interventions [12,13,14,15,16, 18]

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