Are loneliness and cigarettes equally deadly?

I was recently listening to a podcast, and the topic of discussion was the “loneliness epidemic”—a phrase used by public health experts to describe the rising rates of loneliness and social isolation, especially in wealthy, industrialized countries.

I was struck by a statement the guest made that a cigarette smoker with strong friendships will likely live longer than a socially isolated non-smoker. As a former smoker turned fitness trainer, I wanted to learn if there was research that backed up the guest’s claim.

As it turns out, he was referencing a 1965 study that spanned over 30 years in Alameda County, California. It followed nearly 7,000 people and found that those with strong social and community ties lived significantly longer than those who were socially isolated, independent of whether they smoked, drank, or exercised.

For researchers, the takeaways were surprising—a socially isolated non-smoker was more likely to die over the follow-up period than a smoker with close social bonds. In other words, the absence of social relationships was as strong a risk factor for early death as smoking, high blood pressure, or obesity.

Later meta-analyses confirmed this. A 2010 review in PLoS Medicine analyzed 148 studies and concluded that people with stronger social relationships had a nearly 50% higher likelihood of survival, regardless of baseline health.

However, the study’s conclusions do not mean smoking + friendships is “healthier” than not smoking + no friends; rather, that social isolation is a significant mortality risk, sometimes on par with smoking.

Learning about these studies inspired me to reach out to a couple of friends I hadn’t spoken to in quite some time. Additionally, when someone comes to mind and I think, “I should give them a call,” I’ll make a plan to follow through on it.