Sleep, mental health, and socioeconomic factors have a simultaneous effect on the risk of tobacco use but not alcohol use, according to research presented at the 2022 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 4 to 8, 2022, in Charlotte, North Carolina.

The EPISONO (2007) study included individuals who were assessed with the use of the validated Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) questionnaire and polysomnographic examination for 1 night.

The study authors performed a structured equation modeling (SEM) protocol to build a theoretical model in which variables regarding sleep, mental health, and socioeconomic factors could be evaluated for their simultaneous effect on substance use.

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A total of 793 participants (mean age, 43.4 years; 452 women) were included. 

The researchers found significant effects in the tobacco consumption model, as subjective sleep quality, psychiatric symptoms, and socioeconomic status affected participants’ ASSIST scores for tobacco consumption. The effect of psychiatric symptoms on tobacco consumption was mediated by subjective sleep quality.

Models for other substances assessed, such as alcohol, did not demonstrate a statistically significant effect.

“The lack of significance of models for alcohol and other substances may be related to the nature of our sample, in which not many individuals presented a substantial risk of substance involvement that could be detected by the ASSIST questionnaire,” the study authors commented. “However, in the model for tobacco consumption, subjective sleep quality, socioeconomic status, and psychiatric symptoms exerted an effect on tobacco consumption risk, with psychiatric symptoms having their influence mediated by self-perceived sleep quality.”


Dokkedal-Silva V, Fernandes G, Morelhão P, et al. Sleep, mental health and socioeconomic factors concomitantly influence the risk in tobacco consumption. SLEEP 2022; June 4-8, 2022. Abstract 0685.