Europe-wide study provides new insights into relationship between smoking and loneliness

Smoking is associated with increased loneliness, according to an Imperial-led study presented at the European Respiratory Society (ERS) Congress in Barcelona.

The study was presented by Dr Keir Philip, Clinical Lecturer in Respiratory Medicine at the National Heart and Lung Institute, following UK-based research led by his team.

As Dr Philip explained, “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.”

The researchers analysed data from over 50,000 people, across 15 countries, with an average age of 67, participating in the Survey of Health and Ageing in Europe (SHARE). They measured how lonely participants felt using the UCLA loneliness scale, which provides a loneliness score based how often a person feels they lack companionship, feel left out, and feel isolated from others.

The team compared people who were current smokers with people who were not current smokers and followed up with the same questionnaire two years later.

The study found that current smokers were lonelier than non-smokers, even after considering other factors that might influence the results, such as age or gender. People who currently smoked also experienced larger increases in loneliness over time.

Dr Philip told the Congress, “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.

“These findings support and build on previous research and show that the relationship is broadly consistent throughout Europe.”

Dr Philip believes one likely mechanism for smoking leading to increased loneliness is that progressive smoking related illnesses limit mobility, making it more difficult for people to access and participate in social activities.

Another possible explanation is the social norms governing smoking around others. Public smoking bans and smoke-free policies in homes may discourage people who smoke from spending time in these settings, thereby limiting opportunities for social engagement.

Dr Philip believes the next steps are to change the public narrative so that it aligns with the data, saying, “Spreading the word through various routes will be key, from pubs to public policy – the psychosocial impacts of smoking need to be made clear.”

This article is based on the ERS press release (7 September 2026).