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Smokers may have a tougher time finding a job, earn less money

The JAMA Network Journals

Smoking may cost more than the money smokers spend on cigarettes. A new study published online by JAMA Internal Medicine suggests unemployed smokers were less likely to get new jobs and when they did they earned an average of $5 less an hour.

Previous research shows consistent associations between tobacco smoking and unemployment. Employees who smoke cost private employers more money and employers are increasingly taking steps to reduce smoking in the workforce. However, research has not quantified the economic burden of tobacco use for job seekers.

Judith J. Prochaska, Ph.D., M.P.H., of Stanford University, California, and coauthors examined differences in reemployment by smoking status in a 12-month period in a group of 251 unemployed job seekers in San Francisco and Marin counties in California.

Among the 251 participants (131 daily smokers and 120 nonsmokers), 65.7 percent were men and they were an average age of 48. Study participants were 38.2 percent white, 35.9 percent black, 9.6 percent Hispanic, 7.2 percent Asian and 9.2 percent were multiracial or other race. Among the job seekers, 31.1 percent had a college degree and 39.4 percent were unstably housed. The smokers consumed an average of 13.5 cigarettes per day at baseline.

There were 217 participants who completed 12-month follow-up surveys. The authors report that 60 of 108 nonsmokers (55.6 percent) were reemployed compared with 29 of 109 smokers (26.6 percent). The results suggest nonsmokers were 30 percent more likely on average to be reemployed at one year compared with smokers.

Nonsmokers also earned more money. The hourly wage for smokers was about $5 less at an average of $15.10 per hour compared with $20.27 per hour for nonsmokers. At an average of 32 hours per week, this is a deficit of more than $8,300 annually.

The study notes limitations that include exclusion criteria, sample size and participants in a geographic area with a low smoking prevalence and a high stigma about smoking.

"As a 'one-stop shop' for employment resources, employment service agencies could raise awareness of tobacco-related costs, wage losses, health harms and associations with lower reemployment success and serve as a connector to low-cost cessation services such as state quit-lines," the authors conclude.


(JAMA Intern Med. Published online April 11, 2016. doi:10.1001/jamainternmed.2016.0772. Available pre-embargo to the media at

Editor's Note: The article includes conflict of interest and funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Media Advisory: To contact corresponding study author Judith J. Prochaska, Ph.D., M.P.H., call Jennie Dusheck at 650-725-5376 or email

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