A systematic review of loneliness and smoking: small effects, big implications
Open accessAbstract
BACKGROUND: Research supports an association between smoking and negative affect. Loneliness is a negative affective state experienced when a person perceives themselves as socially isolated and is associated with poor health behaviors and increased morbidity and early mortality. OBJECTIVES: In this article, we systematically review the literature on loneliness and smoking and suggest potential theoretical and methodological implications. METHODS: PubMed and PsycINFO were systematically searched for articles that assessed the statistical association between loneliness and smoking. Articles that met study inclusion criteria were reviewed. RESULTS: Twenty-five studies met inclusion criteria. Ten studies were conducted with nationally representative samples. Twelve studies assessed loneliness using a version of the UCLA Loneliness Scale and nine used a one-item measure of loneliness. Seventeen studies assessed smoking with a binary smoking status variable. Fourteen of the studies were conducted with adults and 11 with adolescents. Half of the reviewed studies reported a statistically significant association between loneliness and smoking. Of the studies with significant results, all but one study found that higher loneliness scores were associated with being a smoker. CONCLUSIONS/IMPORTANCE: Loneliness and smoking are likely associated, however, half of the studies reviewed did not report significant associations. Studies conducted with larger sample sizes, such as those that used nationally representative samples, were more likely to have statistically significant findings. Future studies should focus on using large, longitudinal cohorts, using measures that capture different aspects of loneliness and smoking, and exploring mediators and moderators of the association between loneliness and smoking.
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Loneliness and social isolation were found to be associated with increased tobacco use in three systematic reviews.
“Loneliness and social isolation were found to be associated with increased tobacco use in three systematic reviews”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [27]
In one review, a positive association between loneliness and tobacco use was reported in half of the included studies, whereas the other half reported no association or a negative association.
“in one of these reviews a positive association between loneliness and tobacco use was reported in half of the included studies, whereas the other half reported no association or a negative association 27 .”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [27]
The overview found an association (+) between loneliness and tobacco use, supported by one review or multiple lower quality reviews.
“| Tobacco use (Barbosa et al 2012, Dyal & Valente 2015, Seo et al 2012) | + | + | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Dyal & Valente 2015
The overview found an association (+) between social isolation and tobacco use, supported by one review or multiple lower quality reviews.
“| Tobacco use (Barbosa et al 2012, Dyal & Valente 2015, Seo et al 2012) | + | + | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Dyal & Valente 2015
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- Authors
- Dyal, S. R., & Valente, T. W.
- Affiliations
- University of Southern California (US)
- Corresponding author
- Dyal, Stephanie R.
- ORCID
- Valente, Thomas W.
- Venue
- Substance Use & Misuse
- Publisher
- Informa UK Limited
- Published
- 2015-11-10
- Volume
- 50
- Issue
- 13
- Pages
- 1697-1716
- ISSN
- 1082-6084 (ISSN-L)
- 1532-2491
- PMC
- PMC4803029
- OpenAlex
- W2179633763
- Cited by
- 187
- References
- 63
- Citations by year
- 2026: 18 · 2025: 27 · 2024: 20 · 2023: 19 · 2022: 28 · 2021: 19 · 2020: 19 · 2019: 16 · 2018: 11 · 2017: 7 · 2016: 3
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Substance Use & Misuse (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Cancer Institute (R01CA157577)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- loneliness, smoking, social isolation, negative affect, health behavior, UCLA Loneliness Scale, adolescents, sample size effects, mediating and moderating effects
- MeSH terms
- Affect, Female, Humans, Loneliness, Male, Sex Factors, Smoking, Social Isolation, Health Behavior
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