Smokers may become more socially isolated and lonely than non-smokers as they get older, according to a new study co-led by UCL researchers that suggests the idea of smoking as a sociable pastime may be a myth.
Previous research has found that people who are isolated and lonely are more likely to smoke. However, this latest study - which is the first of its kind - found that smoking itself may also lead to higher levels of isolation and loneliness.
The research, published this week in The Lancet Regional Health Europe, examined the relationship between smoking and the development of social isolation and loneliness.
It found that, over time, people who smoked’s social contact reduced, they became less socially engaged and more lonely, compared to non-smokers. With many people who smoke pledging to quit at the start of the new year, the authors hope that their new study will provide another incentive.
Co-author Dr Daisy Fancourt (UCL Institute of Epidemiology & Health) said: "The numerous adverse physical health effects of smoking are well known, but this study shows that smoking is also detrimental to our social behaviours and relationships.
"As the last two years have highlighted, social isolation and loneliness have wide-ranging negative effects on our mental health and wellbeing. As people set New Year’s resolutions for 2022, this provides another reason for stopping smoking to be on the list."
First author Dr Keir Philip, of Imperial College London, said: "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."
He adds: "Our findings contribute to existing knowledge in this area, and suggest the existence of a vicious cycle of smoking, social isolation, and loneliness."
The new study used data from the English Longitudinal Study of Ageing (ELSA), consisting of a nationally representative sample of 8,780 people aged 50 years and older in England. Participants’ social isolation and loneliness were assessed over 12 years (at the outset, then after 4, 8 and 12 years).
The researchers found that, at the outset of the study, current smokers were more likely to be lonely and socially isolated than non-smokers, having less frequent social interactions with family and friends, less frequent engagement with community and cultural activities, and being more likely to live alone.
Smoking was also associated with larger reductions in social contact, increases in social disengagement, and increases in loneliness over time.
These results remained even after considering factors like age, sex, and socioeconomic status.
The study is observational so cannot determine the cause of this association, but the authors speculate that it may be due to a range of factors. For example, smokers are at an increased risk of developing breathlessness and other physical health problems, including lung and heart disease, which limit their ability to socialise. Equally, smoking is associated with an increased risk of mental health problems, such as anxiety and depression, which may impact the amount someone socialises.
In addition, friends of people who smoke are more likely to have smoked themselves and therefore to have died prematurely. Other social factors include the reduced social acceptability of smoking generally, and in particular the expansion of smokefree legislation introduced to reduce the harms from passive smoking.