Cohort trends in prevalence and spousal concordance for smoking

Spousal concordance in the use of alternative tobacco products: A multi-country investigation

BACKGROUND

Married couples often share similar health-related characteristics and behaviors, including cigarette smoking status. Despite their rising popularity in the U.S., little research has examined the patterns of spousal concordance (SC) for alternative tobacco products (ATPs), such as e-cigarettes, cigars, and hookah.

METHODS

The purpose of this project was to examine the roles of age, gender, and culture in the strength of SC for these ATPs. Analyses focused on a diverse community sample of married individuals in Ohio, U.S. (N=278), but also examined patterns in Austria, Greece, Israel, the Netherlands, and Slovakia. All participants completed a survey in which they indicated both their own, and their spouse's ever-use of various tobacco products.

RESULTS

For the U.S. sample, SC was highest for e-cigarettes, flavored e-cigarettes, flavored cigarettes, and hookah (ϕs=0.48- 0.61); SC appeared to be stronger among younger couples, and when there was only a small female vs. male differences in use. Similar patterns were found in the other countries, with a few key exceptions. In particular, there was low SC for e-cigarettes and flavored e-cigarettes in the other countries, where e-cigarettes had been federally regulated by the time of data collection.

CONCLUSION

Overall, these findings have implications for the continued spreading popularity of these tobacco use behaviors.

Spousal resemblance for smoking: Underlying mechanisms and effects of cohort and age

BACKGROUND

In this study we ask why spouses resemble each other in smoking behaviour and assess if such resemblance depends on period of data collection or age. Spousal similarity may reflect different, not mutually exclusive, processes. These include phenotypic assortment (choice of spouse is based on phenotype) or social homogamy at the time spouses first meet, and marital interaction during the relationship.

METHODS

Ever and current smoking were assessed between 1991 and 2013 in surveys of the Netherlands Twin Register for 14,230 twins and 1,949 of their spouses (mean age 31.4 [SD=14.0]), and 11,536 parents of twins (53.4 [SD=8.6]). Phenotypic assortment and social homogamy were examined cross-sectionally by calculating the probability of agreement between twins and their spouses, twins and their co-twin's spouse and spouses of both twins as a function of zygosity. Marital interaction was tested by investigating the association between relationship duration and spousal resemblance.

RESULTS

Between 1991 and 2013 smoking declined in all age groups for both genders. Spousal resemblance for ever and current smoking was higher when data were more recent. For ever smoking, a higher age of men was associated with lower spousal resemblance. Phenotypic assortment was supported for both smoking measures, but social homogamy could not be excluded. No effect of marital interaction was found.

CONCLUSIONS

Differences in smoking prevalence across time and age influence spousal similarity. Individuals more often choose a spouse with similar smoking behaviour (phenotypic assortment) causing higher genotypic similarity between them. Given the heritability of smoking this increases genetic risk of smoking in offspring.

A prospective analysis of smoking and human papillomavirus infection among men in the HPV in Men Study

At present it is unknown whether the higher prevalence of human papillomavirus (HPV) infection among smokers in men is attributed to a higher probability of acquiring an infection or because of longer infection persistence. Thus, we investigated the role of smoking on the incidence (acquisition) and clearance (persistence) of genital HPV infections among 4,026 men in the HPV in Men (HIM) Study, a multinational prospective study of the natural history of genital HPV infection in men. Genital HPV infections were grouped by any, oncogenic and nononcogenic HPV infections and smoking status was categorized as current, former and never smokers. The incidence of any, oncogenic and nononcogenic HPV infections was significantly higher among current smokers compared to former and never smokers (p < 0.01). In multivariable analyses adjusting for sexual behavior and potential confounders, when compared to never smokers, current smokers exhibited significantly higher probability of acquiring any [hazard ratio (HR) = 1.23; 95% confidence interval (CI) 1.02-1.50] and nononcogenic (HR = 1.21; 95% CI 1.00-1.45) infections and a borderline significant probability for oncogenic infections (HR = 1.18; 95% CI 0.98-1.41). Although the median duration of HPV infection was generally longer among current smokers, we found no statistically significant associations in the multivariable analyses. Overall, these results demonstrated that current smoking exhibited the highest incidence and highest probability of acquiring genital HPV infections.

The effect of general and drug-specific family environments on comorbid and drug-specific problem behavior: a longitudinal examination

Previous research has shown that the development of alcohol and tobacco dependence is linked and that both are influenced by environmental and intrapersonal factors, many of which likely interact over the life course. The present study examines the effects of general and alcohol- and tobacco-specific environmental influences in the family of origin (ages 10-18) and family of cohabitation (ages 27-30) on problem behavior and alcohol- and tobacco-specific outcomes at age 33. General environmental factors include family management, conflict, bonding, and involvement. Alcohol environment includes parental alcohol use, parents' attitudes toward alcohol, and children's involvement in family drinking. Tobacco-specific environment is assessed analogously. Additionally, analyses include the effects of childhood behavioral disinhibition, initial behavior problems, and age 18 substance use. Analyses were based on 469 participants drawn from the Seattle Social Development Project (SSDP) sample. Results indicated that (a) environmental factors within the family of origin and the family of cohabitation are both important predictors of problem behavior at age 33; (b) family of cohabitation influences partially mediate the effects of family of origin environments; (c) considerable continuity exists between adolescent and adult general and tobacco (but not alcohol) environments; age 18 alcohol and tobacco use partially mediates these relationships; and (d) childhood behavioral disinhibition contributed to age 33 outcomes, over and above the effects of family of cohabitation mediators. Implications for preventive interventions are discussed.

Non-random mating and convergence over time for alcohol consumption, smoking, and exercise: the Nord-Trøndelag Health Study

Spouses tend to have similar lifestyles. We explored the degree to which spouse similarity in alcohol use, smoking, and physical exercise is caused by non-random mating or convergence. We used data collected for the Nord-Trøndelag Health Study from 1984 to 1986 and prospective registry information about when and with whom people entered marriage/cohabitation between 1970 and 2000. Our sample included 19,599 married/cohabitating couples and 1,551 future couples that were to marry/cohabitate in the 14-16 years following data collection. All couples were grouped according to the duration between data collection and entering into marriage/cohabitation. Age-adjusted polychoric spouse correlations were used as the dependent variables in non-linear segmented regression analysis; the independent variable was time. The results indicate that spouse concordance in lifestyle is due to both non-random mating and convergence. Non-random mating appeared to be strongest for smoking. Convergence in alcohol use and smoking was evident during the period prior to marriage/cohabitation, whereas convergence in exercise was evident throughout life. Reduced spouse similarity in smoking with relationship duration may reflect secular trends.

Smokers with multiple sclerosis are more likely to report comorbid autoimmune diseases

BACKGROUND/AIMS

Smoking is a risk factor for multiple sclerosis (MS) and autoimmune disease, and might explain an increased risk of comorbid autoimmune disease (CAD) in MS. We compared the risk of CAD in smokers and nonsmokers with MS.

METHODS

Participants enrolled in the North American Research Committee on Multiple Sclerosis Registry reported their smoking status, the presence of CAD and the year of diagnosis. We used multivariable logistic regression to determine the independent association between smoking and CAD. We also compared the risk of developing a CAD in current smokers versus never-smokers who did not report any CAD at MS onset, using a proportional hazards model.

RESULTS

Among 8,875 participants reporting comorbidities and smoking status, 1,649 (18.5%) reported a CAD. In a multivariable logistic model, ever-smokers had increased odds of reporting a CAD (odds ratio: 1.22; 95% CI: 1.08-1.38). Among the 7,830 participants without a CAD at onset of MS who reported their smoking status, including the age at which they started smoking, 3,035 (36.8%) currently smoked, while 3,805 (48.6%) never smoked. After adjustment, smokers had an increased risk of developing any autoimmune disease (hazard ratio: 1.23; 95% CI: 1.08-1.41) after MS onset.

CONCLUSION

Smoking is associated with an increased risk of CAD in MS.

Spousal concordance for major coronary risk factors: a systematic review and meta-analysis

Spousal pairs permit assessment of determinants of diseases related to environment, because they share the same lifestyle and environment. The authors reviewed spouses' concordance for the major coronary risk factors. A search of the MEDLINE, PubMed, and EMBASE databases was performed. Seventy-one papers were selected for a total of 207 cohorts of pairs and 424,613 correlations in more than 100,000 couples. The most strongly correlated within-pairs factors were smoking and body mass index, with overall correlations of 0.23 (95% confidence interval: 0.12, 0.36) and 0.15 (95% confidence interval: 0.05, 0.25), respectively. Statistically significant positive correlations were also found for diastolic blood pressure, triglycerides, total and low density lipoprotein cholesterol, weight, and the waist/hip ratio. The overall odds ratios for concordance in hypertension, smoking, diabetes, and obesity were all statistically significant, ranging from 1.16 to 3.25. Assortative mating influenced concordance for blood pressure, smoking, glucose, low density lipoprotein cholesterol, weight, body mass index, and waist circumference. This systematic review shows a statistically significant positive spousal concordance for the majority of main coronary risk factors. However, the strength of the concordance was markedly different among factors and appeared to be quite modest for all of them. Interventions to reduce cardiovascular risk factors should be addressed jointly to both members of a marital couple.