Job strain and health behaviors: results of a prospective study.

PURPOSE: To assess the association between job demands, job decision latitude, and job strain (defined by Karasek as a combination of high demands and low decision latitude) and cardiovascular disease-related health behaviors such as cigarette smoking, alcohol use, lack of exercise, and overweight. DESIGN: Cross-sectional and prospective. SETTING: Nine New York City public and private sector worksites. SUBJECTS: Two hundred eighty-five male employees, aged 30 to 60, in a wide variety of white-collar and blue-collar job titles. MEASURES: Medical examinations and surveys, which included demographic, health behavior, and job characteristics data. RESULTS: Prospectively, among 189 men, increase in job decision latitude over 3 years was associated with decrease in cigarette smoking, by analysis of covariance, controlling for age, race, education, marital status, and number of children at home (F (8, 180) = 4.37, p = .005). The largest increase in latitude occurred among the 13 men who quit smoking. However, change in job characteristics was not associated with change in overweight or alcohol use. Cross-sectional analyses did not produce consistent associations. CONCLUSIONS: The effectiveness of smoking cessation may be aided by modification of structural features of the work environment, such as job decision latitude. This study is limited by the small number of subjects who were engaged in high risk behaviors.