Work Stress and Alcohol Use

by National Institute of Health

Employees who drink heavily or who abuse or are dependent on alcohol can undermine a workforce's overall health and productivity. To better understand the reasons behind employee abusive drinking and to develop more effective ways of preventing problem drinking in the workforce, researchers have developed a number of paradigms that guide their research. One such paradigm is the alienation/stress paradigm, which suggests that employee alcohol use may be a direct or indirect response to physical and psychosocial qualities of the work environment. Although in the alcohol literature, work alienation and work stress traditionally have been treated as separate paradigms, compelling reasons support subsuming the work-alienation paradigm under a general work-stress paradigm. Researchers have developed several models to explain the relationship between work stress and alcohol consumption: the simple cause-effect model, the mediation model, the moderation model, and the moderated mediation model. Of these, the moderated mediation model particularly stands out, because it simultaneously addresses the two fundamental issues of how and when work stressors are related to alcohol use. Recent research supports a relation of work-related stressors to elevated alcohol consumption and problem drinking. Future research should focus on the relation between work stressors and alcohol use among adolescents and young adults, because they are just entering the workforce and are the most likely to engage in heavy drinking. Longitudinal studies also are needed to better explain the relation between work stress and alcohol use.

Employee alcohol use - whether or not it occurs on the job - is an important social policy issue, because it can undermine employee health as well as productivity. From a managerial perspective, the specific problems created by alcohol or other drug (AOD) use may include impaired performance of job-related tasks, accidents or injuries, poor attendance, high employee turnover, and increased health care costs. These outcomes may reduce productivity, increase the costs of doing business and, more generally, impede employers' ability to compete effectively in an increasingly competitive economic environment. It is therefore not surprising that alcohol researchers, as well as researchers in the management and economics fields, take considerable interest in the factors that cause or explain employee alcohol use.

The literature on the causes of employee alcohol use generally takes one of two perspectives. The first perspective views the causes of employee alcohol use as external to the workplace. In other words, an employee may have a family history of alcohol abuse that leaves him or her vulnerable to developing drinking problems, have personality traits reflecting low behavioral selfcontrol that make it difficult to avoid alcohol, or experience social norms and social networks outside work - such as friends who drink heavily - that affect drinking behavior.

Although external factors clearly influence employee drinking habits, a second perspective views the causes of employee alcohol use as arising, at least in part, from the work environment itself. This perspective can be further disaggregated into several narrower paradigms. Although researchers differ somewhat in how they label and categorize those narrower paradigms, three versions appear consistently in the literature:

The social control paradigm suggests that alcohol use may be higher among employees who are not integrated into or regulated by the work organization. Thus, two important risk factors in the social control paradigm are low levels of supervision and low visibility of work behavior.

The culture/availability paradigm suggests that work settings where alcohol is physically or socially available may promote alcohol use among employees.

Physical availability of alcohol at work is defined as the ease with which alcohol can be obtained for consumption on the job, during breaks, and at work-related events. Social availability of alcohol at work is defined as the degree to which fellow workers support drinking either off or on the job.

The alienation/stress paradigm suggests that employee alcohol use may be a response to the physical and psychosocial qualities of the work environment, such as work demands on an employee, an employee's level of boredom, lack of participation in decisionmaking, and interpersonal conflict with supervisors and coworkers.

The remainder of this article focuses on three issues. First, it describes the alienation/stress paradigm in more detail. Second, the article reviews recent research testing the alienation/stress paradigm, focusing on research conducted during the 1990s; this body of research has yet to be reviewed and has become broader and more sophisticated than earlier research testing the alienation/stress paradigm. Finally, the article makes several suggestions for focusing and strengthening future research.

Work-Stress Paradigm

In the alcohol literature, work alienation and work stress typically have been treated as separate paradigms. The work-alienation paradigm focuses on work characteristics that lead to unenriched jobs, such as those in which workers use only minimal skills, have little job control (lack control over the pace of work or its content), and have little or no input into decisionmaking. In contrast, the work-stress paradigm emphasizes other potentially aversive work conditions, which are labeled "work stressors." Common work stressors include dangerous work conditions; noxious physical work environments (conditions that are too hot or cold, noisy, or dirty); interpersonal conflict with supervisors or coworkers; heavy workloads; unfair treatment regarding pay, benefits, and promotions; and job insecurity (threat of layoffs). Trice and Sonnenstuhl argued that the stress and alienation paradigms are conceptually distinct, because the alienation paradigm assumes that work is universally important in people's lives, whereas the stress paradigm does not make this assumption. In other words, the alienation paradigm proposes that factors leading to unenriched jobs will be aversive to all employees, whereas the stress paradigm suggests that work stressors may not be aversive to all employees, because work is not universally important. Although Martin pointed out many similarities between the alienation and stress paradigms, he maintained a distinction between them in his review of the literature.

Four compelling reasons, however, support subsuming the work-alienation paradigm under a general work-stress paradigm:

1. The literature on work stress includes workplace alienation factors in taxonomies of work stressors and in major models of work stress.

2. Both paradigms are based on the assumption that alcohol use represents a means of regulating negative emotions (depression, anxiety, or anger) or thoughts that result from aversive work environments.

3. Despite a basic assumption of the work-alienation paradigm, evidence shows that work does not have a high level of importance in every person's life. Variability in the psychological importance of work exists from person to person.

4. Both theoretical and empirical research suggest that individual differences in the psychological importance of work may be important in explaining when work stressors will be related to alcohol use.

Based on these considerations, this article simply treats work-alienation factors as work stressors.

Even if one subsumes the alienation paradigm into a broad work-stress paradigm, the focus of past work-stress research has been restrictive in that attention has generally focused on stressors that occur within the work role (work demands and conflict with coworkers). Another type of work-related stressor, however, occurs when the demands of work begin to interfere with other social roles. For example, work-family conflict represents the extent to which work and family life interfere with one another. This type of stressor should be incorporated into the work-stress paradigm, because only employed people can experience it. This article, however, separately examines past research on work stressors (withinrole stressors) and work-family conflict (between-role stressors) because they represent qualitatively different aspects of a person's work life.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.