Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of 8,780 older adults in England

Abstract

<b>Background:</b> Smoking is often colloquially considered “social”. However, the actual relationship of smoking with current and future social isolation and loneliness is unclear. We aimed to examine these relationships over a 12-year follow-up. <b>Methods:</b> In this cohort study used a nationally representative sample of community dwelling adults aged 50 years and over from the English Longitudinal Study of Ageing (N=8780) (45% male, mean(SD) age 67(10) years. We examined associations of self-reported smoking status at baseline assessment, with social isolation (low social contact, social disengagement, domestic isolation), and loneliness, measured at baseline, and follow-up at 4, 8 and 12 years. <b>Results:</b> At baseline, smokers were more likely to be lonely (coef.=0·111, 95%CI 0·025–0·196) and socially isolated than non-smokers, having less frequent social interactions with family and friends (0·297, 0·148–0·446), less frequent engagement with community and cultural activities (0·534, 0·421–0·654), and being more likely to live alone (OR=1·400, 95% CI 1·209–1·618). Smoking at baseline was associated with larger reductions in social contact (coef.=0·205, 95%CI 0·053–0·356, to 0·297, 0·140–0·455), increases in social disengagement (0·168, 0·066–0·270, to 0·197, 0·087–0·307), and increases in loneliness (0·105, 0·003–0·207), at 4-year follow-up) over time. No association was found between smoking and changes in cohabitation status. Findings were independent of all identified confounders. <b>Conclusion:</b> Smoking is associated with the development of increasing social isolation and loneliness in older adults, suggesting smoking is detrimental to&nbsp;aspects of psychosocial health.