The association between active smoking, smokeless tobacco, second-hand smoke exposure and insufficient sleep

Background: Studies have shown that cigarette smoking is associated with sleep disorders in the general population. But studies examining the association between smokeless tobacco use, second-hand smoke exposure and insufficient rest/sleep are limited. Methods: We examined the association between smoking, smokeless tobacco use (n = 83,072), second-hand smoke exposure (n = 28,557) and insufficient rest/sleep among adults aged >= 20 years in the state-based 2008 Behavioral Risk Factor Surveillance System. Exposure to second-hand smoke was defined as >1 day of exposure to cigarette smoking either at home or in the workplace in the preceding 7 days. Insufficient rest/sleep was defined as not getting enough rest/sleep everyday in the preceding 30 days. Results: Compared to never smokeless tobacco users, the odds ratio (OR; 95% confidence interval [CI]) of insufficient rest/sleep was 1.16 (1.00-1.36) and 1.74 (1.37-2.22) among former and current users. Compared to non-smokers/non-smokeless tobacco users, the OR (95% Cl) of insufficient rest/sleep for those who were both current smokers and current smokeless tobacco users was 2.21 (1.66-2.94). Regarding second-hand smoke exposure among non-smokers, those with second-hand smoke exposure had higher odds for insufficient rest/sleep than those without. In contrast, the odds of insufficient rest/sleep were similar among current smokers with or without second-hand smoke exposure. Conclusions: In a multiethnic sample of US adults, compared to non-smokers/non-smokeless tobacco users, those who were both current smokers and current smokeless tobacco users had twice the odds of insufficient sleep. Second-hand smoke exposure was associated with insufficient rest/sleep among non-smokers. (C) 2010 Elsevier B.V. All rights reserved.