Summary: Earlier studies linked social isolation and loneliness to higher rates of smoking. This new longitudinal analysis suggests the reverse may also be true: smoking can contribute to growing social isolation and loneliness over time.
Source: Imperial College London
New research shows that smoking is associated not only with well-known physical harms but also with increases in social isolation and loneliness among older adults.
Published in The Lancet Regional Health Europe, the study led by researchers at Imperial College London and University College London analyzed how smoking relates to the development of social isolation and loneliness over a 12-year period.
Using data from the English Longitudinal Study of Ageing (ELSA), the team tracked social contact, engagement in community and cultural activities, living arrangements, and self-reported loneliness. They found that, compared with non-smokers, people who smoked experienced greater reductions in social contact, became less socially engaged, and reported higher levels of loneliness as time went on.
With many smokers resolving to quit at the start of a new year, the researchers say the findings add another reason to stop smoking and reinforce the need for accessible quitting support.
“Our research suggests smoking is bad for aspects of psychological and social health in addition to the well established physical impacts of smoking,” said Dr. Keir Philip of Imperial’s National Heart & Lung Institute, a lead author on the paper.
“Some people think smoking is a social activity, but our study did not support this idea—smokers actually became more socially isolated and lonely than non-smokers over time.”
The study’s authors note their results point to a potential vicious cycle linking smoking, social isolation, and loneliness, and they argue this provides further justification for stepped-up support for people trying to quit.
The analysis used a nationally representative sample of 8,780 adults aged 50 and over living in England. Participants’ levels of social isolation and loneliness were measured at baseline and after 4, 8, and 12 years, allowing the researchers to examine changes over a substantial follow-up period.
At the study’s start, current smokers were more likely than non-smokers to report loneliness and markers of social isolation: they had fewer interactions with family and friends, took part less often in community and cultural activities, and were more likely to live alone.
Over the follow-up period, baseline smoking was linked to larger declines in social contact, greater increases in social disengagement, and higher levels of loneliness. These associations persisted after adjusting for potential confounders such as age, sex, socioeconomic status, and existing physical or mental health diagnoses.
Possible explanations
Because the study is observational, it cannot prove causation. The authors suggest several plausible mechanisms that may explain the link between smoking and worsening social connections:
- Smoking increases the risk of respiratory and cardiovascular conditions that can reduce mobility and stamina, making socializing more difficult.
- Smoking is associated with a higher prevalence of mental health problems such as anxiety and depression, which can lead people to withdraw from social contact.
- Smokers’ social networks may be smaller over time: friends who smoked can experience premature illness and death, reducing opportunities for social interaction.
- Changing social norms and the expansion of smoke-free policies have reduced the social acceptability and settings for smoking, which may further limit smokers’ participation in communal activities.
Professor Nick Hopkinson, another author from Imperial’s National Heart & Lung Institute, emphasized the public health implications: “Most people already know that smoking is a risk to health. Our results suggest that smokers are also more likely to become socially isolated and lonely as they get older.”
He added that these findings support continued policy efforts to reduce smoking prevalence, including measures intended to achieve a smoke-free 2030. The authors also pointed to the value of accessible cessation resources, noting the NHS offers proven tools and advice to help people quit.
About this social isolation research news
Author: Press Office
Source: Imperial College London
Contact: Press Office – Imperial College London
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Original Research: Open access.
“Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England” by Keir EJ Philip et al. Lancet Regional Health Europe
Abstract
Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England
Background
Smoking is often perceived as a social activity, but its relationship with social isolation and loneliness over time remains uncertain. This study examined whether smoking predicts current and future social isolation and loneliness in older adults during a 12-year follow-up.
Methods
This cohort study used a nationally representative sample of community-dwelling adults aged 50 and over from the English Longitudinal Study of Ageing (N=8,780; 45% male; mean age 67±10 years). Researchers assessed self-reported baseline smoking status and measured social isolation (low social contact, social disengagement, domestic isolation) and loneliness (3-item UCLA loneliness scale) at baseline and at 4, 8, and 12 years. Ordinary least squares regression models estimated associations over time.
Findings
At baseline, smokers were more likely to be lonely and socially isolated than non-smokers, reporting fewer interactions with family and friends, lower participation in community and cultural activities, and a higher likelihood of living alone. Baseline smoking was associated with larger declines in social contact, increases in social disengagement, and increases in loneliness over follow-up. These associations remained after adjusting for identified confounders, including age, sex, social class, and the presence of physical and mental health conditions.
Interpretation
The findings indicate that smoking is linked to increasing social isolation and loneliness among older adults, suggesting smoking harms psychosocial as well as physical health. The notion that smoking is inherently prosocial appears to be a misconception.
Funding
UK Economic and Social Research Council & Imperial College London.