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Background  The prevalence of sleep disturbance is high and increasing. The study investigated whether active, former and passive smoking were associated with sleep disturbance.    Methods  This cross-sectional study used data from the UK Biobank: a cohort study of 502 655 participants, of whom 498 208 provided self-reported data on smoking and sleep characteristics. Multivariable multinomial and logistic regression models were used to examine the associations between smoking and sleep disturbance.    Results  Long-sleep duration (&amp;gt;9 h) was more common among current smokers [odds ratio (OR): 1.47; 95% confidence interval (CI): 1.17–1.85; probability value (P) = 0.001] than never smokers, especially heavy (&amp;gt;20/day) smokers (OR: 2.85; 95% CI: 1.66–4.89; P &amp;lt; 0.001). Former heavy (&amp;gt;20/day) smokers were also more likely to report short (&amp;lt;6 h) sleep duration (OR: 1.41; 95% CI: 1.25–1.60; P &amp;lt; 0.001), long-sleep duration (OR: 1.99; 95% CI: 1.47–2.71; P &amp;lt; 0.001) and sleeplessness (OR: 1.47; 95% CI: 1.38–1.57; P &amp;lt; 0.001) than never smokers. Among never smokers, those who lived with more than one smoker had higher odds of long-sleep duration than those not cohabitating with a smoker (OR: 2.71; 95% CI: 1.26–5.82; P = 0.011).    Conclusions  Active and passive exposure to high levels of tobacco smoke are associated with sleep disturbance. Existing global tobacco control interventions need to be enforced.

Tobacco exposure and sleep disturbance in 498 208 UK Biobank participants