Smoking Linked to Greater Loneliness in Adults: ESR

SMOKING may increase loneliness, despite its reputation as a social habit, according to new research.

The research, presented at the European Society of Respiratory Congress this week,  involved more than 51,000 older adults across 14 European countries and Israel and found that current smokers were significantly lonelier than non-smokers.

The findings suggest the harms associated with smoking may extend beyond physical health to social and psychological wellbeing too.

Smoking and Loneliness

The study included 51,532 participants from 14 European countries and Israel, with a mean age of 67 years. More than half (54%) were female, 22% were current smokers, and almost half (48%) were living with two or more chronic illnesses.

Researchers assessed loneliness using the three-item UCLA Loneliness Scale, which gives participants a score ranging from three to nine, with higher scores indicating greater loneliness.

At baseline in 2013, the average loneliness score was 3.8 and participants already smoking had significantly higher loneliness scores compared to the non-smokers.

Importantly, smoking status also appeared to predict how loneliness changed over time. Current smoking at baseline was associated with a greater increase in loneliness at the two-year follow-up.

The findings remained broadly consistent in sensitivity analyses examining participants by age and sex.

Psychosocial Effects of Smoking

Previous research in England has suggested that smoking may be associated with negative psychosocial outcomes. However, researchers questioned then whether this relationship could partly reflect country-specific social norms surrounding smoking or the effects of smoking-related illness.

This latest analysis extends those findings across a much larger group of countries, with researchers reporting broadly consistent results throughout Europe, although some regional variation was observed.

While the observational study cannot establish that smoking directly causes loneliness, the researchers said the findings suggest its consequences could extend beyond its well-established effects on physical health.

The results add to evidence challenging perceptions of smoking as a social activity and suggest that addressing tobacco use could potentially have wider implications for psychosocial health among older adults.

Dr Keir Philip, Clinical Lecturer in Respiratory Medicine at the National Heart and Lung Institute, Imperial College London, said: “Although we know smoking is bad for your physical health, we don’t know what it does to our social health.

“Smoking has been considered a ‘social activity’, but we regularly see people with smoking-related illnesses becoming increasingly socially isolated and lonely,” he added.

Dr Philip insisted that more needs to be done in the way of regulation to curb smoking and the harm it causes. He explained: “Smoking is not social; our research shows it leads to increased social isolation and loneliness. Spreading the word through various routes will be key, from pubs to public policy – the psychosocial impacts of smoking need to be made clear.”

Reference

Philip KEJ et al. The relationship of smoking with current and future loneliness in 15 countries using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). European Respiratory Society (ERS) Congress 2026.

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