۱- Introduction

۲- Methods

۳- Analysis

۴- Results

۵- Discussion

۶-Conclusion

References

Abstract

Introduction: There is mixed evidence regarding the associations between self-esteem and smoking and excessive alcohol consumption. This study aimed to investigate whether self-esteem is associated with smoking status and alcohol consumption in a large sample of adults in the United Kingdom after adjusting for age, sex, socioeconomic status and depressed mood.
Methods:
Design: Cross-sectional correlational study conducted under the aegis of the British Broadcasting Corporation (BBC) between 2009 and 2013.
Participants: 187,398 respondents (67.9% female) with a mean age of 32.82 years (SD = 12.41) providing complete data.
Setting: UK.
Measures: Online self-report questionnaire. The outcomes were smoking status (current smoker, ever smoker) and alcohol consumption (current drinker, excessive drinker); the input variable was self-esteem measured using a Single Item Self-Esteem Scale; covariates were age, sex, SES, and depressed mood measured using a single item question.
Results: The odds of being an ever smoker and a current smoker were greater in people with lower self-esteem (AdjOR 0.97; 95% CI 0.95–۰٫۹۹, Cohen’s d= −۰٫۰۲; and AdjOR 0.96; 95% CI 0.94–۰٫۹۹, Cohen’s d= −۰٫۰۲ respectively). The odds of being a current drinker were lower in people with lower self-esteem (AdjOR 1.20, 95% CI 1.17–۱٫۲۴, Cohen’s d = 0.10) while being an excessive drinker was associated with lower self-esteem (β = −۰٫۱۳, p < 0.001, F(5, 187392) = 997.14, p < 0.001, Cohen’s d = 0.3).
Conclusions: Lower self-esteem appears to be positively associated with ever- and current smoking and excessive alcohol consumption and negatively associated with current alcohol consumption.

Introduction

Smoking and excessive alcohol consumption are major public health concerns and are prevalent in the UK. Globally, around one in seven adults are daily smokers and one in five adults consumes alcohol excessively at least once a month (Peacock et al., 2018). In 2017, 16.8% of the adult population in the UK smoked daily regularly (Office for National Statistics, 2018b) and the prevalence of excessive alcohol consumption, measured as alcohol consumption exceeding 12 (for men)/9 (for women) units of alcohol on their heaviest day in the previous week, was 15% (Office for National Statistics, 2018a). The combination of smoking and alcohol consumption have a greater impact on the disease burden than either behaviour alone (Peacock et al., 2018) and beyond health consequences, bring significant social and economic losses to public health, such as ill-health related costs. Furthermore, in 2017, excessive alcohol consumption was more than twice as common among smokers (17%) than in never smokers (6%) or non-smokers (7%) in the UK (Office for National Statistics, 2018a). Hence it is not surprising that there is a need to identify factors that predict smoking and excessive alcohol consumption to help implement further efforts for smoking cessation and alcohol reduction.