192 female student nurses from 2 hospitals were administered the Middlesex Hospital Questionnaire and a measure of smoking behavior. Sickness and absence data were taken from Ss' training records. Prior to exposure to the work situation, levels of affective distress did not differ significantly between groups differing in smoking behavior (nonsmoker, relaxation smokers, and stress smokers). Multiple regression analysis showed overall significant differences in absence frequency between hospitals and between smokers and nonsmokers. There was also a significant interaction between smoking behavior and affective state; only among the stress smokers did initial level of affective distress predict frequency of absence. Thus, the present study (conducted in a setting that did not permit smoking during working hours), showed that withdrawal from work in direct relation to affective symptom levels occurred only among Ss who habitually smoked in response to stress. (56 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).