Smoking is associated with the amount and duration of sick leave and degree of productivity loss at work.115-117 Smokers are more likely to miss work due to ill-health, have longer duration of absence from work, and access all levels of medical care more frequently.35, 118 Level of consumption also plays a role, with heavier smokers having more absences than lighter smokers.40 Work absences are reportedly higher in smokers resulting from a broad range of symptoms, including problems with the digestive tract, neck, back and upper limbs.118 These effects are evident in younger smokers, before the effects of major tobacco-caused disease become apparent during middle age and later years.35 There is also evidence that smokers are more likely to suffer injury in the workplace than non-smokers.35