Smoking and Stress in the General Population in Denmark
Open accessAbstract
INTRODUCTION: The social pressure placed on smokers today might potentially lead to an increasing level of stress. We investigated if the proportion of persons with high stress level had increased over time more in smokers than in non-smokers. METHODS: Data were obtained from repeated cross-sectional surveys of The Capital Region Health Survey conducted in 2010, 2013 and 2017. Survey data were weighted for survey design and non-response, and linked to national register data. Cohens Perceived Stress Scale (PSS-10) score was used. Logistic regression analyses, based on 136608 citizens' self-reports, were adjusted for sex, age, education level, employment, and alcohol intake (and loneliness, in analysis investigating the associations between tobacco consumption and high stress level). RESULTS: A significantly higher proportion of citizens reported a high stress level in 2017 compared with 2010 and 2013 but there was not a greater increase in smokers than in non-smokers. Daily smoking men had 69% higher odds of reporting perceived high stress level and daily smoking women had 36% higher odds, than never smokers of the same sex. There was a significant trend between higher daily tobacco consumption and a higher proportion of smokers with high stress level. CONCLUSIONS: The increase in high stress level over time occurred independently of smoking status. Daily smokers had the highest odds of perceived high stress level, and a higher daily tobacco consumption was associated with a higher proportion of smokers with high stress level. Smoking cessation programs should, to a higher degree, consider implementing stress-coping elements to prevent relapse.
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The pathway from stress to disease involves environmental demands, perceived stress, negative emotional responses, poor health behaviors, and physiological changes, culminating in a heightened risk of disease onset or progression.
“The pathway from stress to disease involves environmental demands, perceived stress, negative emotional responses, poor health behaviors, and physiological changes, culminating in a heightened risk of disease onset or progression.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [79]
A study of over 136,000 citizens showed a significant correlation between high stress levels and increased tobacco consumption.
“A study of over 136,000 citizens showed a significant correlation between high stress levels and increased tobacco consumption [79,80,81,82].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [79]
Smokers often relapse after cessation programs, citing stress as a major factor.
“Smokers often relapse after cessation programs, citing stress as a major factor.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [79]
Stressful events can trigger affective responses like worry and anxiety, altering the functions of the HPA axis and the SAM system, which can lead to poor health decisions such as decreased exercise, poor sleep, increased smoking, and alcohol consumption, ultimately increasing disease risk.
“Stressful events can trigger affective responses like worry and anxiety, altering the functions of the HPA axis and the sympathetic–adrenal–medullary (SAM) system. This can lead to poor health decisions, such as decreased exercise, poor sleep, increased smoking, and alcohol consumption, which ultimately increase disease risk.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [79]
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Cites
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
UCLA loneliness scale (version 3): reliability, validity, and factor structure
Russell, D. W. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6601_2 · Cited by 5,800 · see citing works
A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004) · Research on Aging · doi:10.1177/0164027504268574 · Cited by 4,781 · see citing works
(2010) · PsycEXTRA Dataset · doi:10.1037/e590462011-001 · Cited by 1,799 · see citing works
The association of cigarette smoking with depression and anxiety: a systematic review
Fluharty, M., Taylor, A. E., Grabski, M., & Munafò, M. R. (2017) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntw140 · Cited by 1,299 · see citing works
Change in mental health after smoking cessation: systematic review and meta-analysis
Taylor, G., McNeill, A., Girling, A., Farley, A., Lindson-Hawley, N., & Aveyard, P. (2014) · BMJ · doi:10.1136/bmj.g1151 · Cited by 1,039 · see citing works
Work stress, smoking status, and smoking intensity: an observational study of 46 190 employees
Kouvonen, A. M., Mika Kivimaki, B., Virtanen, M., Pentti, J., & Vahtera, J. (2004) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2004.019752 · Cited by 311 · see citing works
Stress decreases the ability to resist smoking and potentiates smoking intensity and reward
McKee, S. A., Sinha, R., Weinberger, A. H., Sofuoglu, M., Harrison, E. L., Lavery, M., & Wanzer, J. (2011) · Journal of Psychopharmacology · doi:10.1177/0269881110376694 · Cited by 276 · see citing works
The downside of tobacco control? Smoking and self-stigma: A systematic review
Evans‐Polce, R. J., Castaldelli-Maia, J. M., Schomerus, G., & Evans-Lacko, S. E. (2015) · Social Science & Medicine · doi:10.1016/j.socscimed.2015.09.026 · Cited by 204 · see citing works
Eskildsen, A., Dalgaard, V. L., Nielsen, K. J., Andersen, J. H., Zachariae, R., Olsen, L. R., Jørgensen, A., & Christiansen, D. H. (2015) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3510 · Cited by 195 · see citing works
Slopen, N. B., Kontos, E. Z., Ryff, C. D., Ayanian, J. Z., Albert, M. A., & Williams, D. R. (2013) · Cancer Causes & Control · doi:10.1007/s10552-013-0262-5 · Cited by 194 · see citing works
Self-perceived smoking motives and their correlates in a general population sample
Fidler, J. A., & West, R. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp120 · Cited by 194 · see citing works
The construct validity of the Perceived Stress Scale
Nielsen, M. G., Ørnbøl, E., Vestergaard, M., Bech, P., Larsen, F. B., Lasgaard, M., & Christensen, K. S. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.03.009 · Cited by 181 · see citing works
The impact of implementing tobacco control policies: the 2017 tobacco control policy scorecard
Levy, D. T., Tam, J., Kuo, C., Fong, G. T., & Chaloupka, F. (2018) · Journal of Public Health Management and Practice · doi:10.1097/phh.0000000000000780 · Cited by 174 · see citing works
Increased desire to smoke during acute stress
Perkins, K. A., & Grobe, J. E. (1992) · British Journal of Addiction · doi:10.1111/j.1360-0443.1992.tb03121.x · Cited by 155 · see citing works
Stubbs, B., Veronese, N., Vancampfort, D., Prina, M. A., Lin, P., Tseng, P., Εvangelou, Ε., Solmi, M., Köhler, C. A., Carvalho, A. F., et al. (2017) · Scientific Reports · doi:10.1038/s41598-017-07579-w · Cited by 154 · see citing works
Ritchie, D., Amos, A., & Martin, C. (2010) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntq058 · Cited by 143 · see citing works
New mechanisms and perspectives in nicotine withdrawal
Jackson, K. J., Muldoon, P. P., Biasi, M. D., & Damaj, M. I. (2014) · Neuropharmacology · doi:10.1016/j.neuropharm.2014.11.009 · Cited by 103 · see citing works
The effect of stopping smoking on perceived stress levels
Hajek, P., Taylor, T., & McRobbie, H. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.02979.x · Cited by 99 · see citing works
Posttraumatic stress disorder and cigarette smoking: A systematic review
Kearns, N. T., Carl, E., Stein, A. T., Vujanovic, A. A., Zvolensky, M. J., Smits, J. A. J., & Powers, M. B. (2018) · Depression and Anxiety · doi:10.1002/da.22828 · Cited by 88 · see citing works
Buchmann, A. F., Laucht, M., Schmid, B., Wiedemann, K., Mann, K. F., & Zimmermann, U. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108095716 · Cited by 82 · see citing works
Wosu, A. C., Gelaye, B., Valdimarsdóttir, U. A., Kirschbaum, C., Tobias Stalder, A., Shields, A. E., & Williams, M. A. (2014) · Annals of Epidemiology · doi:10.1016/j.annepidem.2014.11.022 · Cited by 60 · see citing works
Momentary precipitants connecting stress and smoking lapse during a quit attempt.
Cambron, C., Haslam, A. K., Baucom, B., Lam, C. Y., Vinci, C., Cinciripini, P. M., Li, L., & Wetter, D. W. (2019) · Health Psychology · doi:10.1037/hea0000797 · Cited by 44 · see citing works
Helweg‐Larsen, M., Sorgen, L. J., & Pisinger, C. H. (2019) · Social Cognition · doi:10.1521/soco.2019.37.3.294 · Cited by 41 · see citing works
Self-citationThe impact of smoking cessation attempts on stress levels
Kim, S.-J., Chae, W., Park, W.-H., Park, M. H., Park, E., & Jang, S. (2019) · BMC Public Health · doi:10.1186/s12889-019-6592-9 · Cited by 38 · see citing works
Kennedy, B., Chen, R., Fang, F., Valdimarsdóttir, U. A., Montgomery, S., Larsson, H., & Fall, K. (2019) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2018-211815 · Cited by 35 · see citing works
Welch, A. E., Jasek, J. P., Caramanica, K., Chiles, M. C., & Johns, M. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.01.023 · Cited by 32 · see citing works
Cambron, C., Hopkins, P. D., Burningham, C., Lam, C. Y., Cinciripini, P. M., & Wetter, D. W. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.107840 · Cited by 30 · see citing works
The impact of early life stress on risk of tobacco smoking initiation by adolescents
Iakunchykova, O. P., Andreeva, T., Nordstrom, D. L., Shkiryak-Nizhnyk, Z. A., Antipkin, Y., Hryhorczuk, D. O., Звінчук, О., & Chislovska, N. (2015) · Addictive Behaviors · doi:10.1016/j.addbeh.2015.06.014 · Cited by 27 · see citing works
Parnia, A., & Siddiqi, A. (2019) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2019-213357 · Cited by 23 · see citing works
Amplified reacquisition of nicotine self-administration in rats by repeated stress during abstinence
Yu, G., Chen, H., & Sharp, B. M. (2014) · Psychopharmacology · doi:10.1007/s00213-014-3501-x · Cited by 12 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [3]U.S. Department of Health and Human Services The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General 2014 Atlanta, GA U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health https://www.ncbi.nlm.nih.gov/books/NBK179276/pdf/Bookshelf_NBK179276.pdf. Accessed January 22, 2021
Cited by
Sorted by citations
Shchaslyvyi, A. Y., Antonenko, S. V., & Telegeev, G. D. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21081077 · Cited by 73 · see citing works
Diabetic retinopathy as a potential marker of Parkinson’s disease: a register-based cohort study
Larsen, M. E. C., Thykjær, A. S., Pedersen, F. N., Möller, S., Laugesen, C. S., Andersen, N., Andresen, J., Hajari, J. N., Heegaard, S., Højlund, K., et al. (2021) · Brain Communications · doi:10.1093/braincomms/fcab262 · Cited by 10 · see citing works
Vallarta‐Robledo, J. R., Marques-Vidal, P. M., Sandoval, J. L., Ridder, D. D., Schaffner, E., Humair, J., Cornuz, J., Probst-Hensch, N. M., Joost, S., & Guessous, I. (2022) · Health & Place · doi:10.1016/j.healthplace.2022.102845 · Cited by 8 · see citing works
Wong, V. W.-H., Yiu, E. K. L., Ng, C. H., Sarris, J. J., & Ho, F. Y. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.12.079 · Cited by 6 · see citing works
Sustained decline in tobacco purchasing in Denmark during the COVID-19 pandemic
Fosgaard, T. R., Pizzo, A., & Sadoff, S. (2022) · Communications Medicine · doi:10.1038/s43856-022-00160-1 · Cited by 6 · see citing works
Choi, E. J., Seo, H., Kim, K. H., & Jung, S. (2025) · BMC Public Health · doi:10.1186/s12889-025-21644-4 · Cited by 4 · see citing works
Honnudóttir, V., Veyhe, A. S., Mohr, M., Strøm, M., & Mohr, M. (2023) · Scandinavian Journal of Public Health · doi:10.1177/14034948231176708 · Cited by 4 · see citing works
Gu, W., Liu, X., Sun, R., Jiang, Y., Cao, Z., Wu, M., Ma, J., Chen, Z., Chen, Y., Zhang, Y., et al. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2021.740064 · Cited by 3 · see citing works
Shayea, A. M. F., Alshatti, A., Alfadhli, D. H., Ibrahim, A. F., Almutairi, M. K., & Nadar, M. S. (2023) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-023-04271-w · Cited by 2 · see citing works
Rasmussen, M., Santini, Z. I., Joshanloo, M., Petersen, C. B., & Christensen, A. I. (2025) · International Journal of Public Health · doi:10.3389/ijph.2025.1608531 · Cited by 2 · see citing works
From traits to puffs: The interplay of personality, pandemic stress, and smoking behaviors
Tian, Y., Xiang, W., Dzhugaryan, S., Bae, D., Barrington‐Trimis, J. L., & Church, T. D. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316301 · Cited by 1 · see citing works
Bjerkén, A. P. B., Ahrensberg, H., Andersen, S., Aadahl, M., Christensen, A. I., & Petersen, C. B. (2025) · European Journal of Public Health · doi:10.1093/eurpub/ckaf220 · Cited by 1 · see citing works
Kjeld, S. G., Thygesen, L. C., Danielsen, D., Jensen, M. P., Krølner, R. F., Pisinger, C. H., & Andersen, S. (2024) · BMJ Open · doi:10.1136/bmjopen-2022-070176 · Cited by 1 · see citing works
Self-citationKjeld, S. G., Homberg, T., & Andersen, S. (2024) · Scandinavian Journal of Public Health · doi:10.1177/14034948241227305 · Cited by 1 · see citing works
Estrés percibido como predictor del consumo de tabaco en hombres y mujeres
Valdez-Piña, E., Mandujano, J. L., Cruz-Morales, S. E., & López, M. V. (2024) · African journal of rhetoric · doi:10.21134/haaj.v24i1.779 · Cited by 1 · see citing works
A Narrative Inquiry into the Meaning of Smoking among Farmworkers in Southern Philippines
Malinda, R. P., & Flor, B. P. G. (2024) · Southeastern Philippines Journal of Research and Development · doi:10.53899/spjrd.v29i2.457 · Cited by 1 · see citing works
Yang, T., Peng, S., Wu, D., & Rockett, I. R. H. (2022) · Tobacco Induced Diseases · doi:10.18332/tid/154077
Bukhari, H. A., & Alqurashi, J. H. (2023) · Medical Science · doi:10.54905/disssi/v27i137/e306ms3075
Makaginsar, C., & Yuniarti, Y. (2024) · Global Medical & Health Communication (GMHC) · doi:10.29313/gmhc.v12i2.13842
Mensah, E. O., Ghevolor, A. J., Obi-Ani, N. A., & Umukoro, G. M. (2025) · Sociological Focus · doi:10.1080/00380237.2025.2473473
Eficacia de una intervención para dejar de fumar con entrenamiento para la gestión del estrés
Valdez-Piña, E., Mandujano, J. L., & Escartín-Pérez, R. E. (2025) · Ansiedad y Estrés · doi:10.5093/anyes2025a3
Lim, K. H., Cheong, Y. L., Lim, J.-N., Kee, C. C., Ghazali, S. M., Cheah, Y. K., Heng, P. P., Marine, A. A., Hashim, M. H. M., Goh, W. W., et al. (2025) · Tobacco Induced Diseases · doi:10.18332/tid/204789
Shayea, A. M. F., AlRumaihi, A. K., & AlSabah, A. K. (2026) · Journal of Orthopaedic Surgery and Research · doi:10.1186/s13018-026-06954-6
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Glancy, C., Carroll, T. O., Ruairc, B. Ó., Gildea, J., Malone, K. M., Lane, A., Guérandel, A., & Gallagher, M. (2026) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-026-04588-5
- Authors
- Buhelt, L., Pisinger, C., & Andreasen, A.
- Affiliations
- Frederiksberg Hospital (DK)
- University of Copenhagen (DK)
- Corresponding author
- Buhelt, Lone
- Venue
- Tobacco Prevention & Cessation
- Publisher
- E.U. European Publishing
- Published
- 2021-04-13
- Volume
- 7
- Issue
- April
- Pages
- 1-9
- ISSN
- 2459-3087 (ISSN-L)
- PMC
- PMC8040741
- OpenAlex
- W3154931408
- Cited by
- 24
- References
- 31
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 3 · 2022: 3 · 2021: 2
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Tobacco Prevention & Cessation (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- smoking, perceived stress, tobacco use, daily smoking, sex differences, loneliness, smoking cessation interventions, relapse prevention, stress coping
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