Longer absence from work due to childbirth may lead to increased smoking

Extended periods of absence of work due to childbirth could increase the risk of unhealthy behaviours, particularly smoking, according to a new study published in the Journal of Health Economics. 

A team, including Mujaheed Shaikh, Professor of Health Governance at the Hertie School, alongside Anna-Theresa Renner (TU Wien) and Sonja Spitzer (University of Vienna), analysed data from 14 European countries spanning 1960 to 2010 from over 8,500 mothers. They combined policy information on maternity and parental leave with individual birth, employment, and health histories of women to assess the long-term effects on smoking behaviour.

A nuanced picture of maternal leave

The study found that each additional month of leave increases a woman’s likelihood of smoking later in life by around 1.2 percentage points, prolongs her lifetime smoking duration by seven months, raises daily cigarette consumption by 0.2 cigarettes, and boosts overall pack-years by 0.6 . These findings highlight potential unintended consequences of prolonged leave durations.

Crucially, the effect is non linear . Shorter leave periods appear protective against smoking, whereas very long absences, roughly beyond 20 months, may raise the likelihood of harmful health behaviours.

“Designing effective parental leave requires balancing time away from work, financial security, and fair responsibility sharing between both parents”

The authors point to a potential mediating factor: financial strain. Women who lacked financial support from their partners during leave, despite statutory benefits, exhibited higher increases in smoking duration, suggesting that economic stress may drive coping behaviours like smoking.

“Leave policies do more than support families in the short term; they shape health trajectories over decades,” explains Prof. Shaikh. “Designing effective parental leave requires balancing time away from work, financial security, and fair responsibility sharing between both parents.”

Policy implications and next steps

The study offers key insights for policymakers across Europe and beyond. By underscoring the crucial link between financial stress on mothers during maternal leave and unhealthy behaviours, the authors call for a nuanced approach to family leave policies.

They suggest that moderate-length leave, combined with robust financial support, may achieve public health and maternal well-being goals. Policies encouraging stronger public health and support for the wellbeing of mothers should be encouraged.

The complete study, “Absence from work and lifetime smoking behavior: Evidence from European maternal leave policies”, is available here: https://www.sciencedirect.com/science/article/pii/S0167629625000396

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