Associations between self-esteem and smoking and excessive alcohol consumption in the UK: A cross-sectional study using the BBC UK Lab database

INTRODUCTION: There is mixed evidence regarding the associations between self-esteem and smoking and excessive alcohol consumption. This study aimed to investigate whether self-esteem is associated with smoking status and alcohol consumption in a large sample of adults in the United Kingdom after adjusting for age, sex, socio-economic status and depressed mood. METHODS: Design: Cross-sectional correlational study conducted under the aegis of the British Broadcasting Corporation (BBC) between 2009 and 2013. Participants: 187,398 respondents (67.9% female) with a mean age of 32.82 years (SD = 12.41) providing complete data. Setting: UK. MEASURES: Online self-report questionnaire. The outcomes were smoking status (current smoker, ever smoker) and alcohol consumption (current drinker, excessive drinker); the input variable was self-esteem measured using a Single Item Self-Esteem Scale; covariates were age, sex, SES, and depressed mood measured using a single item question. RESULTS: The odds of being an ever smoker and a current smoker were greater in people with lower self-esteem (AdjOR 0.97; 95% CI 0.95–0.99, Cohen’s d = −0.02; and AdjOR 0.96; 95% CI 0.94–0.99, Cohen’s d = −0.02 respectively). The odds of being a current drinker were lower in people with lower self-esteem (AdjOR 1.20, 95% CI 1.17–1.24, Cohen’s d = 0.10) while being an excessive drinker was associated with lower self-esteem (β = −0.13, p < 0.001, F(5, 187392) = 997.14, p < 0.001, Cohen’s d = 0.3). CONCLUSIONS: Lower self-esteem appears to be positively associated with ever- and current smoking and excessive alcohol consumption and negatively associated with current alcohol consumption.