I remember the sinking feeling when I first read that loneliness could be as deadly as smoking 15 cigarettes a day. At the time, I often felt lonely, caught between wanting to reassure myself I was okay and desperately searching for ways to feel ‘normal.’ Those headlines made my struggles feel like a ticking time bomb inside me.

The original claim came from a 2010 paper (Holt-Lunstad, J., Smith, T. B., & Layton, J. B), a meta analysis which looked at 148 papers and evaluated the social predictors of mortality.  The Editors’ Summary found that “people with stronger social relationships had a 50% increased likelihood of survival than those with weaker social relationships.” It’s helpful that these sorts of studies from the medical community draw attention to the importance of social relationships, and the impact of loneliness. And by comparing loneliness to other more established risk factors (such as cigarettes) it increases the salience and importance of giving resources and attention to this issue.  Holt- Lunstad, one of the authors of the study, spoke about the importance of these kinds of papers to help clinicians understand more about these social factors, and how they can begin to address this with patients. 

While medicalizing loneliness raises awareness and resources, it also risks reducing a deeply personal and social experience to a clinical problem. For example, someone who already feels like an outlier might internalise this framing as further evidence that they are broken or abnormal, rather than recognizing loneliness as a broader societal issue. Additionally: 

1. It flattens the issue, and risks making it one dimensional. Our social connections are more than a medical matter, they reflect how society is organised, where resources are in society, who experiences trauma, and more. 
2. It can leave people who are lonely feeling like they are even more of a problem. It may increase self consciousness about loneliness. In the UK this may be heightened because all health costs are paid for from the public purse. 
3. Pathologising loneliness can feel  determinative.  And while everyone will die, all these studies can do is describe populations, they can’t tell you much less about individuals. 
4. The comparison to cigarettes gives the impression that just like stopping smoking, it might be possible for a lonely person to stop being lonely. For some people, loneliness is a temporary signal to join in more activities, but for many people who are experiencing chronic loneliness, it just isn’t that simple. 

I think it is important to keep studying the impact of loneliness and in particular the mechanisms that are at work leaving people with weaker connections with (on average) worse health outcomes. This needs to be balanced by research from other disciplines, including social research, place based studies, social economics, social psychology and more. I think we need to be wary of using medicalised language, which may end up furthering the stigmatisation of people experiencing a lack of the social connection they want. 

Ultimately, addressing loneliness requires more than a prescription—it demands a collective effort to foster environments where connection is possible. Whether through community initiatives, more inclusive public spaces, or personal steps toward connection. 

Reference

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLOS Medicine, 7(7), e1000316.

DOI:10.1371/journal.pmed.1000316

Subramanian, I. and Holt-Lunstad, J. (2024). Loneliness: Time for Medicine to Address This Risk Factor. [online] Medscape. Available at: https://www.medscape.com/viewarticle/loneliness-time-medicine-address-this-risk-factor-2024a1000gj4?form=fpf.