Occupational gradients in smoking behavior and exposure to workplace environmental tobacco smoke: the multi-ethnic study of atherosclerosis.

OBJECTIVE: This study examines associations of occupation with smoking status, amount smoked among current and former smokers (number of cigarettes per day and lifetime cigarette consumption (pack-years)), and workplace exposure to environmental tobacco smoke (ETS) independent from income and education.

METHODS: This is a cross-sectional analysis of data from a community sample (n = 6355, age range: 45-84) using logistic and multinomial regression. All analyses were stratified by sex and adjusted for socio-demographic variables.

RESULTS: Male blue-collar and sales/office workers had higher odds of having consumed more than 20 pack-years of cigarettes than managers/professionals. For both male and female current or former smokers, exposure to workplace ETS was consistently and strongly associated with heavy smoking and greater pack-years.

CONCLUSIONS: Blue-collar workplaces are associated with intense smoking and ETS exposure. Smoking must be addressed at both the individual and workplace levels especially in blue-collar workplaces.