Objective This study aimed to examine the association between job strain (combination of job demands and job control) and alcohol-related health problems among men and women and the extent to which workplace social support moderates this association.

Methods This study used information from the register-based Swedish Work, Illness, and Labor-market Participation (SWIP) cohort, focusing on working individuals born 1945–1975, who were registered in Sweden in 2005 (N=2 822 462). Job demands, control and workplace social support were measured using job exposure matrices (JEM). Information on alcohol-related health problems (morbidity, mortality, medication prescription, sickness absence and disability pension) was obtained from multiple registers between 2006 and 2020. Cox regression models were employed to estimate associations between job strain and alcohol-related health problems, adjusting for sociodemographic background and previous health. The modifying effect of social support was assessed using relative excess risk due to interactions (RERI).

Results High-strain and passive jobs were related to an increased risk of alcohol-related health problems among both men [hazard ratios (HR) 1.28 and 1.32] and women (HR 1.06 and 1.05), after adjusting for important individual and parental covariates. Weak social support had diverging associations with the outcome for men and women. Strong social support appeared to buffer the risk in passive jobs but only among women (RERI=0.08).

Conclusions In Sweden, job strain seems to influence alcohol-related health problems, particularly among men. Women, however, appear to experience the protective effects of strong work-related social support measured at the occupational level.

Key terms alcohol; alcohol consumption; alcohol-related health problem; job control; job demand; job strain; register-based cohort study; social support; Sweden; work environment

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