[Cigarette smoking and psychosocial work stress in middle-management employees].
The association between psychosocial work stress and cigarette smoking is analyzed in a socioeconomically and professionally homogeneous group of 163 middle managers (40-55 years; 48.4 +/- 4.5) in a large industrial company. Psychosocial stress is defined in terms of an imbalance between effort spent and reward obtained at work. The relative risk of regular smoking is 4.34 (odds ratio after controlling for age; 95% CI 1.50-12.54) in those middle managers who suffer from a marked imbalance between effort and reward, compared to those who are free from this type of psychosocial stress at work. This effect persists in the older age group although the proportion of smokers decreases with age. Within the group of regular smokers, every second middle manager suffering from a marked imbalance between effort and reward is a heavy smoker (greater than or equal to 20 cigarettes/day) whereas in the group experiencing less stress at work, only 28% heavy smokers are found. However, due to small numbers this difference is not statistically significant. In conclusion, the data reported in this study demonstrate an association between psychosocial stress at work in terms of high effort and low reward and the risk of regular smoking. This association is not confounded by age, socio-economic status or type of occupation.