Cigarette smoking and alcohol use as predictors of disability retirement: A population-based cohort study

Drug Alcohol Depend. 2015 Oct 1;155:260-6. doi: 10.1016/j.drugalcdep.2015.06.047. Epub 2015 Aug 10.


Background: This study investigated how cigarette smoking and alcohol use predict disability retirement.

Methods: Data from the longitudinal nationwide Finnish Twin Cohort study were analyzed, with clustered study design applied when computing 95% confidence intervals (CI). The sample included 21,719 individuals. Smoking and alcohol use were assessed with a questionnaire in 1975. Registry data on retirement events up till end of 2004 were obtained from the Social Insurance Institution and the Finnish Centre for Pensions.

Results: Disability pension was granted to 4251 participants. Among men, adjusted for age and alcohol use, former (HR=1.45, 95%CI 1.28, 1.65, p<.001) and daily smokers (HR=1.93, 95%CI 1.71, 2.17, p<.001) showed elevated disability pension risk compared to never smokers. Among women, daily smokers (HR=1.25, 95%CI 1.11, 1.40, <.001) had elevated risk. The age and smoking adjusted risk estimates for alcohol were elevated among abstainers (men HR=1.41, 95%CI 1.21, 1.65, p<.001; women HR=1.36, 95%CI 1.23, 1.52, p<.001) and heavy drinkers (men HR=1.30, 95%CI 1.18, 1.43, p<.001; women HR=1.34, 95%CI 1.04, 1.72, p=.026). Those being persistent smokers and binge drinkers had over three-fold disability risk compared to those who were binge drinkers but had only a few smoking years (men: HR=3.32, 95%CI 2.43, 4.54, p<.001; women: HR=4.05, 95%CI 2.05, 8.00, p<.001). Among men and women who were not binge drinkers, longer smoking duration was needed for elevated disability risk.

Conclusions: Both smoking and excess alcohol use significantly predict disability retirement. In order to extend working careers, more attention should be paid to health behaviors, in addition to working conditions.

Keywords: Alcohol; Disability; Pension; Smoking.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / epidemiology*
  • Disabled Persons / psychology
  • Disabled Persons / statistics & numerical data*
  • Educational Status
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pensions / statistics & numerical data
  • Registries
  • Retirement / statistics & numerical data*
  • Risk Factors
  • Smoking / epidemiology*
  • Young Adult