A large study across Europe shows that smoking damages social health and increases loneliness over time.
RT’s Three Key Takeaways:
- Increased Loneliness: A Europe-wide study of more than 50,000 adults found that individuals who smoke report higher levels of loneliness and experience greater increases in social isolation over time compared to non-smokers.
- Underlying Mechanisms: Researchers noted that mobility limitations caused by progressive respiratory illness and public smoke-free policies may restrict social engagement for people who smoke.
- Cessation Support: Experts highlight smoking as a modifiable risk factor for loneliness, calling for non-stigmatizing cessation interventions in healthcare settings and public policy.
Smoking is not a social habit and leads to increased loneliness, according to a Europe-wide study presented at ERS 2026.
“Although we know smoking is bad for your physical health, we don’t know what it does to our social health. Previous research has suggested that loneliness leads to smoking, but there has been very little research asking if smoking leads to loneliness. Smoking has been considered a ‘social activity’, but we regularly see people with smoking-related illnesses becoming increasingly socially isolated and lonely,” said Dr Keir Philip, clinical lecturer in respiratory medicine at the National Heart and Lung Institute, Imperial College London.
“Our first study in England suggested that people who smoked became lonelier than those who didn’t smoke, but it was possible the results were influenced by culture and social norms. We wanted to investigate if we saw the same relationship between smoking and loneliness across other countries too,” said Dr Keir Philip, clinical lecturer in respiratory medicine at the National Heart and Lung Institute, Imperial College London.
Evaluating Loneliness Across European Populations
Investigators evaluated data from more than 50,000 participants across 15 countries who took part in the Survey of Health and Aging in Europe (SHARE), according to the study authors. Researchers assessed loneliness using the University of California, Los Angeles (UCLA) loneliness scale, which scores how often respondents report lacking companionship, feeling left out, and feeling isolated from others.
The investigators compared participants who currently smoked with non-smokers and reevaluated them two years later using the same questionnaire, according to the research team. The average age of participants was 67, with 22% identifying as active smokers at baseline, and 48.5% reporting more than two chronic medical conditions.
According to the study results, current smokers were lonelier than non-smokers, even after adjusting for potential confounding variables including age and gender. Furthermore, individuals who smoked experienced larger increases in loneliness over time after accounting for demographic characteristics, health factors, and baseline loneliness scores. The relationship was consistent across European regions, with only slight regional variations reported.
“Smoking is associated with increasing loneliness in older people, suggesting smoking may damage psychosocial health in addition to physical effects. These findings support and build on previous research and show that the relationship is broadly consistent throughout Europe,” said Dr Keir Philip, clinical lecturer in respiratory medicine at the National Heart and Lung Institute, Imperial College London, in a news release.
Physical and Social Barriers to Connection
The researchers suggested multiple mechanisms explaining the observed association. Progressive respiratory conditions and smoking-related illnesses frequently restrict physical mobility, making it more challenging for patients to participate in community activities and maintain social networks, according to the authors.
“Another potential mechanism relates to social norms around smoking around other people. Smoking bans in public places and informal smoke free environments in people’s homes may make such places less appealing to people who smoke, which could limit the potential for social interactions,” said Dr Keir Philip, clinical lecturer in respiratory medicine at the National Heart and Lung Institute, Imperial College London.
Dr Philip emphasized that shifting the narrative around smoking is essential. “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,” said Dr Keir Philip, clinical lecturer in respiratory medicine at the National Heart and Lung Institute, Imperial College London.
Implications for Healthcare and Cessation Efforts
The findings also highlight the need to address smoking as an actionable risk factor within broader public healthcare strategies aimed at reducing isolation in older populations.
“This is important information for people who smoke. It is vital to support people to quit smoking without stigmatizing them. From individual to policy level, these findings demonstrate that as well as damaging physical health, smoking appears to damage aspects of psychosocial health. The idea that smoking might be ‘social’ should be challenged, as the evidence indicates the opposite,” said Des Cox, clinical professor at University College Dublin and member of the European Respiratory Society Advocacy Council, in a news release.
“With loneliness now recognized as one of the key public health challenges of our time, this research identifies smoking as an important risk factor for loneliness, and it’s a factor for which effective treatments exist. We need to do all we can to help smokers to quit and to make sure young people do not become addicted to nicotine,” said Des Cox, clinical professor at University College Dublin and member of the European Respiratory Society Advocacy Council, in a news release.
