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San Sebastián M, Jaakko T, Söderberg S, Zimmet P, Ori B, Heecharan J, Fonseca-Rodríguez O, Kowlessur S. Prevalence and social determinants of smoking among men in Mauritius: a cross-sectional study. Glob Health Action 2024; 17:2367415. [PMID: 38899339 PMCID: PMC11191822 DOI: 10.1080/16549716.2024.2367415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Mauritius has implemented a range of stringent policies to control smoking and promote public health. Regular monitoring focuses on the prevalence of tobacco use, yet there is a gap in understanding its socio-economic patterns. OBJECTIVE The aim of this study was to estimate the prevalence of tobacco smoking and to identify the social determinants associated with smoking among men in Mauritius in 2021. METHODS This is a cross-sectional population-based study conducted by the Ministry of Health and Wellness during 2021. In total, 3622 individuals participated (response rate of 84.1%), of which 1663 were men (45.9%). The study mainly focused on men given the low prevalence of smoking among women. Daily smoking was the outcome and a series of sociodemographic and socioeconomic factors were included as independent variables. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were estimated to fulfill the study objective. RESULTS The prevalence of smoking among men was 30.4%. People in the 25-34 age group (PR = 1.65; 95% CI: 1.12-2.41), those separated, divorced or widowed (PR = 1.57; 95% CI: 1.16-2.11), the ethnic groups Muslim-Mauritians (PR = 1.70; 95% CI: 1.00-2.89) and Creoles (PR = 1.97; 95% CI: 1.16-3.35), and those with secondary (PR = 1.29; 95% CI: 1.00-1.67) and primary education (PR = 1.47; 95% CI: 1.10-1.98) were statistically significantly associated with daily smoking. CONCLUSIONS Although a gradual decline in smoking prevalence was observed compared with the previous 2015 survey, the Ministry of Health and Wellness should persist in fortifying its anti-smoking measures and concentrate on crafting tailored interventions aimed at the vulnerable groups identified in this study.
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Affiliation(s)
| | - Tuomilehto Jaakko
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of International Health, National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Stefan Söderberg
- Department of Public Health and Clinical Medicine, Umea university, Umea, Sweden
| | - Paul Zimmet
- Department of Diabetes, Central Clinical School, Monash University, Melbourne, Australia
| | - Bhushan Ori
- Ministry of health and Wellness, Port Louis, Mauritius
| | - Jaysing Heecharan
- Non-communicable Diseases, Health Promotion and Research Unit, Ministry of Health and Wellness, Port Louis, Mauritius
| | | | - Sudhirsen Kowlessur
- Non-communicable Diseases, Health Promotion and Research Unit, Ministry of Health and Wellness, Port Louis, Mauritius
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Caglayan-Akay E, Ertok-Onurlu M, Komuryakan F. Tobacco control policies and the multidimensional context of tobacco use by gender: The case of Türkiye. Int J Health Plann Manage 2024; 39:1584-1602. [PMID: 39090527 DOI: 10.1002/hpm.3835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/18/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE This study aims to determine the indicators of tobacco use in Türkiye within a multidimensional context as socio-demographic, physical, behavioural, and psychological as a response to the tobacco control policies. METHODS The Turkish Health Survey data in 2014 and 2019 are employed within a probit model approach and the differences in tobacco are decomposed use by gender in order to reveal the gender differences. The samples in 2014 (total n = 19,129; males = 8 721, females = 10,408) and 2019 (total n = 17,084; males = 7 784, females = 9300) were restricted to 15-year-old and above. RESULTS The findings indicate that being in the 30-49 age cohort, having lower education, and being married increase the likelihood of tobacco use. Future policies and campaigns should specifically target the single, pre-obese, employed males who consume alcohol. For females, the gender-specific policies should aim to reduce the prevalence of smoking, especially among separated or widows, obese, and out of the labour force. The contribution of mental health indicators on tobacco use has declined over the 5 years, which could be a result of the supportive free health services in Türkiye. The findings provide evidence for a significant and increasing gender difference in tobacco use in Türkiye along with reporting that the most significant contributors to gender differences in tobacco use are alcohol consumption and education level. CONCLUSION Even though the Ministry of Health and the government have been implementing anti-tobacco policies, legislations, and campaigns for years, the tobacco use prevalence has remained high and even increased in Türkiye.
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Affiliation(s)
| | - Merve Ertok-Onurlu
- Biga Faculty of Economics and Administrative Sciences, Çanakkale Onsekiz Mart University, Çanakkale, Türkiye
| | - Fulden Komuryakan
- Faculty of Economics and Administrative Sciences, Bandırma Onyedi Eylül University, Balıkesir, Türkiye
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Long JD, Gehlsen MP, Moody J, Weeks G, Philibert R. Predictors of Smoking in Older Adults and an Epigenetic Validation of Self-Report. Genes (Basel) 2022; 14:genes14010025. [PMID: 36672765 PMCID: PMC9912258 DOI: 10.3390/genes14010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
There are several established predictors of smoking, but it is unknown if these predictors operate similarly for young and old smokers. We examined clinical data from the National Lung Screening Trial (NLST) to determine the predictive ability of gender, body mass index (BMI), marital status, and race on smoking behavior, with emphasis on gender interactions. In addition, we validated the self-report of smoking behaviors for a subgroup that had available epigenetic data in the form of cg05575921 methylation. Participants were N=9572 current or former smokers from the NLST biofluids database, age 55-74, minimum of 30 pack years, and mostly White. A subgroup of N=3084 who had DNA were used for the self-report validation analysis. The predictor analysis was based on the larger group and used penalized logistic regression to predict the self-report of being a former or current smoker at baseline. Cg05575921 methylation showed a moderate ability to discriminate among former and current smokers, AUC = 0.85 (95% confidence interval = [0.83, 0.86]). The final selected variables for the prediction model were BMI, gender, BMI by gender, age, divorced (vs. married), education, and race. The gender by BMI interaction was such that males had a higher probability of current smoking for lower BMI, but this switched to females having higher current smoking for overweight to obese. There is evidence that the self-reported smoking behavior in NLST is moderately accurate. The results of the primary analysis are consistent with the general smoking literature, and our results provide additional specificity regarding the gender by BMI interaction. Body weight issues might play a role in smoking cessation for older established smokers in a similar manner as younger smokers. It could be that women have less success with cessation when their BMI increases.
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Affiliation(s)
- Jeffrey D. Long
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, IA 52242, USA; (J.D.L.); (J.M.); (G.W.)
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa, IA 52242, USA
| | - Michael P. Gehlsen
- South Saint Paul Public Schools, 104 5th Ave. S, South Saint Paul, MN 55075, USA;
| | - Joanna Moody
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, IA 52242, USA; (J.D.L.); (J.M.); (G.W.)
| | - Gracie Weeks
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, IA 52242, USA; (J.D.L.); (J.M.); (G.W.)
| | - Robert Philibert
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa, IA 52242, USA; (J.D.L.); (J.M.); (G.W.)
- Behavioral Diagnostics LLC, 2500 Crosspark Rd., Suite W245, Coralville, IA 53341, USA
- Department of Biomedical Engineering, University of Iowa, Iowa, IA 52242, USA
- Correspondence:
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Marital Disruption and Disparity in Tobacco Use in Reproductive-Aged Women: Evidence from India. WOMEN 2022. [DOI: 10.3390/women2040034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Marital disruption defined as widowhood, divorce, or separation, has adverse consequences for women’s health and wellbeing. Extant evidence, however, is primarily available for older women or in developed country settings. Consequences of marital disruption for younger women in the developing countries is relatively less visited. The aim of this cross-sectional study is to assess whether maritally disrupted women of reproductive age (18–49 years) had differential risk of tobacco-use compared to their married counterparts. Using nationally representative data from India, we estimated multivariable logistic regressions to obtain the odds in favor of tobacco-use for maritally disrupted women. We found that compared to women remained in marriage, maritally disrupted women were 1.5 times (95% CI: 1.4–1.6) more likely to consume tobacco. The higher risk of tobacco-use of maritally disrupted women was evident in both younger (age 18–34) and older (age 35–49) cohorts. The results were robust across urban and rural areas, high- and low- education groups, and poor- and non-poor households. The higher odds of tobacco-use among maritally disrupted women persisted even after accounting for household fixed effects. The study findings thus, have implications for strengthening targeted tobacco control policies and health promotion among maritally disrupted women in low-and-middle income countries.
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Hillebrandt MA. Impact of changes in relationship status on smoking behavior and body weight. ECONOMICS AND HUMAN BIOLOGY 2022; 44:101077. [PMID: 34844097 DOI: 10.1016/j.ehb.2021.101077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/06/2021] [Accepted: 10/28/2021] [Indexed: 06/13/2023]
Abstract
This paper examines whether and how changes in relationship status (i.e., cohabitation, marriage, separation, or divorce) affect individuals' smoking behavior and body weight. Using German Socio-Economic Panel data, this study accounts for differences between treated (i.e., those affected by a specific family event) and untreated participants since treatment and control groups differ with respect to several characteristics such as age, which may bias the results. Therefore, regression-adjusted matching is employed for each family event separately. This study, thus, takes steps towards disentangling causality from correlation. Overall, changes in family composition (such as moving together with or separating from the partner) impact the probability to start or quit smoking and lead to changes in body weight. In particular, smoking behavior and body weight are predominantly affected by forming or dissolving a household, rather than by marriage or divorce: cohabitation leads to weight gain; separation from a partner leads to weight loss, increased smoking initiation, and decreased smoking cessation.
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Suñer-Soler R, Grau-Martín A, Terceño M, Silva Y, Maldonado E, Gras ME, Font-Mayolas S, Rodrigo-Gil J, Serena J. A clinical trial comparing smoking cessation interventions at two levels of intensity in stroke patients, stratified by the presence of insular cortex lesions. Nicotine Tob Res 2021; 24:44-52. [PMID: 34245288 DOI: 10.1093/ntr/ntab144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/09/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Smoking is a stroke risk factor but the most efficient way to promote cessation is unknown. The smoking behavior in patients during the first 2 years post-stroke is studied comparing brief advice and intensive behavioral counseling interventions, taking into consideration biological, psychological, and social factors. METHODS Randomized clinical trial of 196 stroke patients, stratified by the presence or not of an insular cortex lesion, with two levels of smoking cessation intervention. RESULTS The study retention rate was 85.2%. Abstinence point prevalence at three months after stroke was 50% in the brief advice group and 51.7% in the intensive behavioral counseling group (p =.82) and at 24 months, 48.3% in the brief group and 47.5% in the intensive group (p =.92). Most relapses occurred in the first weeks. After 3 months the curves separated with fewer events in the intensive group and at 24 months the Hazard Ratio was 0.91 (95% CI = 0.61 to 1.37; p =.67).Twenty-four months after stroke, patients with an insular lesion were more likely to be abstinent (OR 3.60, 95% CI = 1.27 to 10.14), as were those who lived with a partner (OR 2.31, 95% CI = 1.17 to 4.55) and those who were less dependent (OR 0.84, 95% CI = 0.73 to 0.97). CONCLUSIONS A high percentage of patients gave up smoking in both intervention groups with no significant differences between the two. The effect of the insular lesion on smoking cessation, which is early and continued after two years, is particularly notable.
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Affiliation(s)
- Rosa Suñer-Soler
- Department of Nursing and Health and Health Care Research Group, University of Girona, Girona, Catalonia, Spain
| | - Armand Grau-Martín
- Fundació Salut Empordà, Figueres Hospital and Quality of Life Research Institute, University of Girona, Catalonia, Spain
| | - Mikel Terceño
- Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, IDIBGI, Girona, Catalonia, Spain
| | - Yolanda Silva
- Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, IDIBGI, Girona, Catalonia, Spain
| | | | - Maria Eugenia Gras
- Quality of Life Research Institute, University of Girona, Catalonia, Spain
| | | | - Joana Rodrigo-Gil
- Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, IDIBGI, Girona, Catalonia, Spain
| | - Joaquín Serena
- Stroke Unit, Department of Neurology, Hospital Universitari Dr. Josep Trueta de Girona, IDIBGI, Girona, Catalonia, Spain
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Noguchi T, Kondo F, Nishiyama T, Otani T, Nakagawa-Senda H, Watanabe M, Imaeda N, Goto C, Hosono A, Shibata K, Kamishima H, Nogimura A, Nagaya K, Yamada T, Suzuki S. The impact of marital transitions on vegetable intake in middle-aged and older Japanese adults: a five-year longitudinal study. J Epidemiol 2020; 32:89-95. [PMID: 33071250 PMCID: PMC8761567 DOI: 10.2188/jea.je20200343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Marital transitions are associated with adverse health events, such as mortality and cardiovascular disease. Since marital transitions (eg, becoming widowed) are unavoidable life events, it is necessary to identify modifiable intermediate outcomes. Thus, we examined the association between marital transitions and vegetable intake among middle-aged and older Japanese adults. Methods This longitudinal study included Japanese adults aged 40–79 years who received an annual health checkup between 2007 and 2011 (baseline) and 5 years later (follow-up). Marital transitions were classified as whether and what type of transition occurred during the 5-year period and comprised five groups: consistently married, married to widowed, married to divorced, not married to married, and remained not married. Changes in total vegetable, green and yellow vegetable, and light-colored vegetable intake from baseline to follow-up were calculated using the Food Frequency Questionnaire. Results Data from 4,813 participants were analyzed (mean age, 59.4 years; 44.1% women). Regarding marital transitions, 3,960 participants were classified as “consistently married,” 135 as “married to widowed,” 40 as “married to divorced,” 60 as “not married to married,” and 529 as “remained not married.” Multivariable linear regression analysis revealed that compared to consistently married, married to widowed was inversely associated with the change in total vegetable intake (β = −16.64, SE = 7.68, P = 0.030) and light-colored vegetable intake (β = −11.46, SE = 4.33, P = 0.008). Conclusion Our findings suggest that being widowed could result in a reduced intake of vegetables. Hence, dietary counseling according to marital situation is necessary.
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Affiliation(s)
- Taiji Noguchi
- Department of Social Science, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology.,Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Fumi Kondo
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takeshi Nishiyama
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Takahiro Otani
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Hiroko Nakagawa-Senda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Miki Watanabe
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Nahomi Imaeda
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Nutrition Science, Faculty of Health Science, Shigakkan University
| | - Chiho Goto
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutrition, Faculty of Health and Living, Nagoya Bunri University
| | - Akihiro Hosono
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Atsuta Public Health Center, City of Nagoya
| | - Kiyoshi Shibata
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Health and Nutritional Sciences, Nagoya Keizai University
| | - Hiroyuki Kamishima
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Home Economics, Aichi Gakusen University
| | - Akane Nogimura
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences.,Department of Anesthesiology and Intensive Care Medicine, Nagoya City University Graduate School of Medical Sciences
| | - Kenji Nagaya
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
| | - Tamaki Yamada
- Okazaki Public Health Center, Okazaki Medical Association
| | - Sadao Suzuki
- Department of Public Health, Nagoya City University Graduate School of Medical Sciences
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Evedove AUD, Loch MR. Health risk behaviors in elderly Brazilian widowers. Salud Colect 2020; 16:e2255. [PMID: 32222142 DOI: 10.18294/sc.2020.2255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 12/17/2019] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to compare the prevalence of health risk behaviors among elderly widowers with that of elderly partnered males, as well as single or divorced/separated men. Additionally, we set out to examine the prevalence of risk behaviors in elderly widowered men according to age, education level, and race/skin color. A cross-sectional study was conducted with elderly men (≥ 60 years) who were interviewed through the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) in 2016 (n=5,384) and 2017 (n=5,801). The Vigitel survey includes representative samples of adults residing in the capitals of Brazilian states and the Federal District, and of those surveyed, 886 were widowers. Identified risk behaviors included physical inactivity during leisure time, irregular consumption of fruits, vegetables and legumes, smoking and alcohol abuse. The prevalence of smoking was lower among partnered elderly men [PR=0.68, CI95% (0.52-0.90)] than among widowers. There were no differences in the prevalence of other risk behaviors between widowers and other groups. When only widowers were taken into account, there was significant association of risk behaviors with age and educational level, but not with race/skin color.
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Affiliation(s)
- André Ulian Dall Evedove
- Magíster en Salud Colectiva. Programa de Saúde Coletiva, Universidade Estadual de Londrina, Londrina, Brasil.
| | - Mathias Roberto Loch
- Doctor en Salud Colectiva. Programa de Pós Graduação em Saúde Coletiva, Universidade Estadual de Londrina, Londrina, Brasil.
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Martin JL, Barnes I, Green J, Reeves GK, Beral V, Floud S. Social influences on smoking cessation in mid-life: Prospective cohort of UK women. PLoS One 2019; 14:e0226019. [PMID: 31809509 PMCID: PMC6897408 DOI: 10.1371/journal.pone.0226019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/19/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Decisions to quit smoking are thought to be influenced by social factors such as friends, family and social groups, but there have been few attempts to examine comprehensively the influence of a range of social factors on smoking cessation. In the largest study to date, we examined whether smoking cessation was associated with marital status and the smoking habits of a partner, socio-economic status and social participation. METHODS In the prospective Million Women Study, 53,650 current smokers in 2001 (mean age 58.3, SD 4.4) reported their smoking status 4 years later; and reported on social factors on both occasions. Logistic regression yielded odds ratios (ORs) and 99% confidence intervals (CIs) for stopping smoking in the next 4 years by marital status, whether their partner smoked, deprivation, education, and participation in social activities. RESULTS 31% (16,692) of the current smokers at baseline had stopped after 4 years. Smokers who were partnered at baseline were more likely to quit than those who were not partnered (OR 1.13, 99% CI 1.06-1.19). Compared to having a partner who smoked throughout, those who had a non-smoking partner throughout were more likely to quit (OR 2.01, 99% CI 1.86-2.17), and those who had a partner who smoked at baseline but stopped smoking in the next 4 years were even more likely to quit (OR 6.00, 5.41-6.67). There was no association with cessation for education or deprivation. The association with social participation varied by type of activity but was null overall. CONCLUSION Women who were partnered were most likely to stop smoking if their partner also stopped smoking. There was little evidence of a strong influence of either socio-economic status or social participation on smoking cessation. These results emphasise the importance of a spouse's smoking habits on the likelihood of a smoker successfully quitting smoking.
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Affiliation(s)
- Jaime L. Martin
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne University, Melbourne, Victoria, Australia
| | - Isobel Barnes
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom
| | - Jane Green
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom
| | - Gillian K. Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom
| | - Valerie Beral
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom
| | - Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kindom
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Behrendt CE, Cosgrove CM, Johnson NJ, Altekruse SF. Are associations between psychosocial stressors and incident lung cancer attributable to smoking? PLoS One 2019; 14:e0218439. [PMID: 31220129 PMCID: PMC6586400 DOI: 10.1371/journal.pone.0218439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 06/03/2019] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To learn whether reported associations between major psychosocial stressors and lung cancer are independent of smoking history. METHODS Subjects were at least 25 years old and without lung cancer at enrollment in the United States Census Bureau's National Longitudinal Mortality Survey in 1995-2008. Follow-up via Surveillance Epidemiology and End Results and National Death Index continued until lung cancer diagnosis, death, or December 2011. Involuntary unemployment, widowhood, and divorce, stratified by sex, were tested for association with subsequent lung cancer using proportional hazards regression for competing risks. Smoking status, years smoked, cigarettes per day, and years since quitting were imputed when missing. RESULTS At enrollment, subjects (n = 100,733, 47.4% male, age 49.1(±15.8) years) included 17.6% current smokers, 23.5% former smokers. Of men and women, respectively, 11.3% and 15.0% were divorced/separated, 2.9% and 11.8% were widowed, and 2.9% and 2.3% were involuntarily unemployed. Ultimately, 667 subjects developed lung cancer; another 10,071 died without lung cancer. Adjusted for age, education, and ancestry, lung cancer was associated with unemployment, widowhood, and divorce/separation in men but not women. Further adjusted for years smoked, cigarettes per day, and years since quitting, none of these associations was significant in either sex. CONCLUSIONS Once smoking is accounted for, psychosocial stressors in adulthood do not independently promote lung cancer. Given their increased smoking behavior, persons experiencing stressors should be referred to effective alternatives to smoking and to support for smoking cessation.
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Affiliation(s)
- Carolyn E. Behrendt
- Biostatistics and Epidemiology, Information Sciences, City of Hope National Medical Center, Duarte, California, United States of America
| | - Candace M. Cosgrove
- Mortality Research Branch, United States Census Bureau, Suitland, Maryland, United States of America
| | - Norman J. Johnson
- Mortality Research Branch, United States Census Bureau, Suitland, Maryland, United States of America
| | - Sean F. Altekruse
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
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Public Facility Utility and Third-Hand Smoking Exposure without First and Second-Hand Smoking According to Urinary Cotinine Level. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050855. [PMID: 30857230 PMCID: PMC6427616 DOI: 10.3390/ijerph16050855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 01/09/2023]
Abstract
Third-hand smoke (THS) causes pathological changes in the liver, lungs, and skin. THS exposure can be ubiquitous, chronic, and unconscious. However, little is known about THS exposure in public facilities and its susceptible population. This paper aimed to identify which public facilities and socio-demographic groups were especially vulnerable to THS. Data from 1360 adults obtained from Korean National Environmental Health Survey I (2009–2011) were analyzed. To study the sole effect of THS, we restricted the study population to those participants who had never smoked and who had no exposure to second-hand smoke. The assessed variables included the type and frequency of public transportation, frequency of use of 12 different public facilities, and 8 socio-demographic factors. Urinary cotinine was used as a biomarker. T-tests and analysis of variance were used for univariate analyses, while generalized linear regression was used for multivariate analysis. Frequent use of public transportation, bars, internet cafés, and participants with low levels of education, divorced or bereaved, living in multi-unit houses, and with smokers within the family were associated with significantly high urinary cotinine levels. These findings indicate that the frequent use of public transportation, certain public facilities and certain socio-demographic factors can result in high THS exposure.
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Alkan Ö, Abar H. Determination of factors influencing tobacco consumption in Turkey using categorical data analyses 1. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2019; 75:27-35. [PMID: 30652517 DOI: 10.1080/19338244.2018.1556200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of this study is to specify factors influencing tobacco consumption in Turkey, which belongs to developing countries group, and to determine the extent of their influence. Factors related to the sociodemographic, economic, personal, environmental, and healthy life indicators influencing tobacco consumption in Turkey were determined using logistic and probit regression analyses. According to the results of the study, age, gender, education, marital status, fruit consumption, exposure to tobacco smoke at home, and frequent of alcohol consumption are the most influential variables effecting tobacco consumption. More effective results in policies aimed at preventing tobacco consumption can be accomplished by giving priority to individuals more inclined to tobacco consumption. People in 25-44 age group, men, graduates of high school and its equivalents, divorced/widowed individuals, individuals exposed to tobacco smoke, and alcohol users are individuals who tend to use tobacco.
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Affiliation(s)
- Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
| | - Hayri Abar
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Turkey
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Bricard D, Legleye S, Khlat M. Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060610. [PMID: 28590412 PMCID: PMC5486296 DOI: 10.3390/ijerph14060610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/22/2017] [Accepted: 05/31/2017] [Indexed: 11/16/2022]
Abstract
The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration.
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Affiliation(s)
- Damien Bricard
- Institut de Recherche et Documentation en Économie de la Santé (Irdes), 117 bis rue Manin, 75019 Paris, France.
- Institut National d'Études Démographiques (Ined), 133 boulevard Davout, 75020 Paris, France.
| | - Stéphane Legleye
- Institut National de la Statistique et des Études Économiques (Insee), 6 Rue Legrand, 92240 Malakoff, France.
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP), Faculté de Médecine-Université Paris-Sud, Faculté de Médecine-UVSQ, INSERM, Université Paris-Saclay, 94805 Villejuif, France.
| | - Myriam Khlat
- Institut National d'Études Démographiques (Ined), 133 boulevard Davout, 75020 Paris, France.
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Trias-Llimós S, Muszyńska MM, Cámara AD, Janssen F. Smoking cessation among European older adults: the contributions of marital and employment transitions by gender. Eur J Ageing 2017; 14:189-198. [PMID: 28579935 PMCID: PMC5435786 DOI: 10.1007/s10433-016-0401-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Knowledge about the potential effects of stressful events on smoking cessation is helpful for the design of health interventions. Previous studies on this topic tended to group together adults of all ages and of both genders. We investigate the contribution of marital and employment losses on smoking cessation by gender, specifically among older adults in Europe. We used panel data from waves 4 (2011) and 5 (2013) of the Survey of Health, Ageing and Retirement in Europe for 3345 male and 3115 female smokers at baseline aged 50 and over from 13 countries. The associations between marital and employment losses and smoking cessation were derived from logistic regression models for each gender, controlling for age, educational attainment, diseases incidence and country of residence. Interactions between gender and marital and employment losses were tested. Over the analysed period, 119 smokers became widowed or divorced (1.8 %), 318 became retired (4.9 %) and 100 became unemployed (1.5 %). Becoming widowed or divorced was associated with lower probability of smoking cessation among both men (OR 0.36, 95 % CI 0.14-0.94) and women (OR 0.46, 95 % CI 0.21-0.99). Transitions to unemployment and to retirement were not significantly associated with smoking cessation (OR 0.62, 95 % CI 0.25-1.49; and OR 0.68, 95 % CI 0.43-1.07, respectively). Gender differences in the association between marital and employment losses and smoking cessation were not statistically significant (p value > 0.05 for all interactions). Health interventions should take into account that male and female older adults affected by marital loss are at risk of continuing smoking.
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Affiliation(s)
- Sergi Trias-Llimós
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, The Netherlands
| | - Magdalena M. Muszyńska
- Institute of Statistics and Demography, Warsaw School of Economics, Al. Niepodległości 162, 02-554 Warsaw, Poland
| | - Antonio D. Cámara
- Department of Business Management, Marketing and Sociology, University of Jaén, Campus de las Lagunillas, s/n Edificio D-3 (dep. 007), 23071 Jaén, Spain
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, Lange Houtstraat 19, 2511 CV The Hague, The Netherlands
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Peltonen R, Ho JY, Elo IT, Martikainen P. Contribution of smoking-attributable mortality to life expectancy differences by marital status among Finnish men and women, 1971-2010. DEMOGRAPHIC RESEARCH 2017; 36:255-280. [PMID: 28127255 PMCID: PMC5260839 DOI: 10.4054/demres.2017.36.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Smoking is known to vary by marital status, but little is known about its contribution to marital status differences in longevity. We examined the changing contribution of smoking to mortality differences between married and never married, divorced or widowed Finnish men and women aged 50 years and above in 1971-2010. DATA AND METHODS The data sets cover all persons permanently living in Finland in the census years 1970, 1975 through 2000 and 2005 with a five-year mortality follow-up. Smoking-attributable mortality was estimated using an indirect method that uses lung cancer mortality as an indicator for the impact of smoking on mortality from all other causes. RESULTS Life expectancy differences between the married and the other marital status groups increased rapidly over the 40-year study period because of the particularly rapid decline in mortality among married individuals. In 1971-1975 37-48% of life expectancy differences between married and divorced or widowed men were attributable to smoking, and this contribution declined to 11-18% by 2006-2010. Among women, in 1971-1975 up to 16% of life expectancy differences by marital status were due to smoking, and the contribution of smoking increased over time to 10-29% in 2006-2010. CONCLUSIONS In recent decades smoking has left large but decreasing imprints on marital status differences in longevity between married and previously married men, and small but increasing imprints on these differences among women. Over time the contribution of other factors, such as increasing material disadvantage or alcohol use, may have increased.
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Affiliation(s)
- Riina Peltonen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
| | - Jessica Y Ho
- Sanford School of Public Policy and Population Research Institute, Duke University, Durham, NC, USA
| | - Irma T Elo
- Department of Sociology, Population Aging Research Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland; Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden; Max Planck Institute for Demographic Research, Rostock, Germany
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17
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Brenn T, Ytterstad E. Increased risk of death immediately after losing a spouse: Cause-specific mortality following widowhood in Norway. Prev Med 2016; 89:251-256. [PMID: 27311340 DOI: 10.1016/j.ypmed.2016.06.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 04/25/2016] [Accepted: 06/12/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This paper examines the short-term risk of cause-specific death following widowhood. METHOD We followed all individuals registered as married in Norway in 1975 for marital status and mortality until 2006. Widowed individuals were followed for mortality for 7years following widowhood. Causes of death were categorized into five cause-groups. Life tables were used in survival analyses. RESULTS Deaths among the widowed were most frequent in the week following widowhood. In this week and compared to married individuals, there were more deaths including those from malignant cancer in men (hazard ratio (HR) of 1.51; 95% CI: 1.12, 1.89), from external causes in men (HR=3.64; 95% CI: 2.01, 5.28), and from respiratory diseases (HR=2.18; 95% CI: 1.52, 2.84 in men and HR=3.18; 95% CI: 2.26, 4.09 in women). A majority of respiratory deaths were from pneumonia. Thereafter excess mortality among the widowed dropped gradually. Although these numbers stabilized, they were still elevated in year 7. Excess mortality was particularly high in the youngest age group considered (55-64years) and decreased with age, though more so in men than in women. Only a few more widowed individuals than expected died of a condition in the same cause-group as their spouses. CONCLUSION A novel finding was that excess deaths in the week following widowhood also were from cancer and respiratory diseases. Men in the youngest age group seemed most vulnerable. Prevention should be considered directly after the death of a spouse, and measures should be aimed at virtually all causes of death.
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Affiliation(s)
- Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
| | - Elinor Ytterstad
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, N-9037 Tromsø, Norway.
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18
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Lindström M, Giordano GN. Changes in Social Capital and Cigarette Smoking Behavior Over Time: A Population-Based Panel Study of Temporal Relationships. Nicotine Tob Res 2016; 18:2106-2114. [PMID: 27113013 DOI: 10.1093/ntr/ntw120] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/19/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Identifying factors that influence individuals' smoking behavior remains a huge public health concern. This study aimed to investigate changes in individuals' cigarette smoking while considering well-known smoking determinants, including social capital, its presence being postulated to reduce smoking. METHODS From British Household Panel Survey data, two baseline smoking cohorts were created ("smoking" and "not smoking"). The same individuals from this nationally representative sample (NT = 8114, aged 16-91 years) were interviewed on four occasions between years 2000 and 2007 to investigate changes in cigarette smoking behavior. Logistic regression models with random effects compensated for within-individual behavior over time. Temporal pathways were investigated by lagging independent variables (t - 1) in relation to our cigarette-use outcome at time (t). RESULTS Active social participation at (t - 1) was positively associated with smoking cessation at (t) (odds ratio [OR] = 1.39; 95% confidence interval [CI] [1.07-1.82]). Separating from one's spouse at (t - 1) increased risk for smoking relapse/initiation at (t) (OR = 6.63; 95% CI [1.70-28.89]). Conversely, being married protected against smoking cigarettes (OR = 1.87; 95% CI [1.15-3.04]). These associations held in our robustness checks. CONCLUSIONS Initial marital breakdown predicted a high risk of smoking relapse/initiation. The timing of this life event provides a critical window where adverse smoking behavior might occur. Conversely, the positive effects of active social participation on cigarette cessation remained consistent, its absence further predicting smoking relapse/initiation. Robustness of results confirms the important role that active participation has on cigarette smoking behavior. Group smoking cessation interventions could harness participatory elements to better achieve their goals. IMPLICATIONS By investigating temporal relationships between well-known smoking determinants and cigarette smoking outcomes, we identified that being "separated" (not "divorced") at time (t) predicted a higher risk of smoking relapse/initiation at (t). Tailored health messages could be employed to highlight the increased risk of cigarette smoking relapse/initiation during this stressful life event. Conversely, active social participation (a common social capital proxy) consistently predicted smoking cessation over time. Future group smoking cessation interventions could be designed explicitly to harness participatory elements to better achieve their goals.
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Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Lund, Sweden.,Centre for Economic Demography (CED), Lund University, Lund, Sweden
| | - Giuseppe N Giordano
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Lund, Sweden.,Centre for Economic Demography (CED), Lund University, Lund, Sweden
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Rezayatmand R, Pavlova M, Groot W. Socio-economic Aspects of Health-Related Behaviors and Their Dynamics: A Case Study for the Netherlands. Int J Health Policy Manag 2015; 5:237-51. [PMID: 27239865 DOI: 10.15171/ijhpm.2015.212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 12/19/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Previous studies have mostly focused on socio-demographic and health-related determinants of health-related behaviors. Although comprehensive health insurance coverage could discourage individual lifestyle improvement due to the ex-ante moral hazard problem, few studies have examined such effects. This study examines the association of a comprehensive set of factors including socio-demographic, health status, health insurance, and perceived change in health insurance coverage with health-related behaviors and their dynamics (ie, changes in behavior). METHODS Using Survey of Health, Aging, and Retirement in Europe (SHARE) data (a European aging survey among 50+ years old) for the Netherlands in 2004 and 2007 (sample size: 1745), binary and multinomial logit models are employed to study health-related behaviors (daily smoking, excessive alcohol use, and physical inactivity in 2004) and their corresponding changes (stopping or starting unhealthy behavior between 2004 and 2007). RESULTS Our findings show that being older, being female, having higher education and living with a partner increase the likelihood not to be a daily smoker or to stop daily smoking. At the same time, being older (OR = 3.02 [1.31, 6.95]) and being female (OR = 1.77 [1.05, 2.96]) increases the likelihood to be or to become physically inactive. We also find that worse perceived health insurance coverage in 2007 is associated with a lower likelihood (OR = 0.19 [0.06, 0.57]) of stopping excessive alcohol use in that year. However, we do not find a strong association between the type of health insurance and health behavior. CONCLUSION Our findings show that all above mentioned factors (ie, socio-demographic and health status factors) are associated with health-related behavior but not in a consistent way across all behaviors. Moreover, the dynamics of each behavior (positive or negative change) is not necessarily determined by the same factors that determine the state of that behavior. We also find that better perceived health insurance coverage is associated with a healthier lifestyle which is not compatible with an ex-ante moral hazard interpretation. Our results provide input to target policies towards elderly individuals in need of lifestyle change. However, further research should be done to identify the causal effect of health insurance on health-related behavior.
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Affiliation(s)
- Reza Rezayatmand
- Health Management and Economics Research Center (HMERC), Isfahan University of Medial Sciences, Isfahan, Iran.,Department of Health Services Research, CAPHRI, FHML, Maastricht University, Maastricht, The Netherlands
| | - Milena Pavlova
- Department of Health Services Research, CAPHRI, FHML, Maastricht University, Maastricht, The Netherlands
| | - Wim Groot
- Department of Health Services Research, CAPHRI, FHML, Maastricht University, Maastricht, The Netherlands.,Top Institute for Evidence-Based Education Research (TIER), Maastricht University, Maastricht, The Netherlands
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20
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Kriegbaum M, Christensen U, Andersen PK, Osler M, Lund R. Does the association between broken partnership and first time myocardial infarction vary with time after break-up? Int J Epidemiol 2014; 42:1811-9. [PMID: 24415614 DOI: 10.1093/ije/dyt190] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Marriage is associated with lower risk of coronary heart disease, but it is unknown if the association depends on time since break-up with a partner. In this study we included both married and unmarried couples to study if the association between broken partnership (BP) and first time incident myocardial infarction (MI) changes with time since BP. METHODS Register study of the entire Danish population: the population was restricted to those aged 30 to 65 years with follow-up for incident MI between 1985 and 2006 with an annual record on each individual; in total 43 million records. The register data were used to identify MI events. Poisson regression was used to study associations between time since BP and MI adjusted for socio-demographic confounders and hospital admissions. Analyses were stratified by sex. RESULTS Compared with unexposed (no BP), the incidence rate ratio (IRR) of MI in men with BP in the same year was 0.97 [95% confidence interval (CI) 0.90-1.05], year before BP was 1.25 (95% CI 1.17-1.34), 2-3 years after BP was 1.12 (95% CI 1.06-1.18), 4-8 years after BP was 1.09 (95% CI 1.05-1.14) and 9+ years since BP was 1.09 (95% CI 1.05-1.12). In women, the IRR same year as BP was 1.45 (95% CI 1.26-1.66), the year after BP was 1.30 (95% CI 1.14-1.50), 2-3 years after BP was 1.26 (95% CI 1.13-1.39), 4-8 years after BP was 1.17 (95% CI 1.08-1.26) and 9+ years since BP was 1.24 (95% CI 1.17-1.32). CONCLUSIONS We found both a short-term elevated risk of first time MI following BP and a weaker long-term elevated risk, in both men and women.
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Affiliation(s)
- Margit Kriegbaum
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark and Glostrup University Hospital, Copenhagen, Denmark
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Hong O, Duffy SA, Choi SH, Chin DL. The association between occupational exposures and cigarette smoking among operating engineers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2014; 69:172-179. [PMID: 24325748 PMCID: PMC3863785 DOI: 10.1080/19338244.2013.763760] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The purpose of this study was to determine the relationship between occupational exposures and cigarette smoking among operating engineers. A cross-sectional survey was conducted with operating engineers (N = 412) from a midwestern state in the United States. The survey included validated questions on cigarette smoking, occupational exposures, demographics, comorbidities, and health behaviors. About 35% were current smokers. Those exposed to asphalt fumes, heat stress, concrete dust, and welding fumes were less likely to smoke (odds ratio [OR] = .79, 95% confidence interval [CI]: .64-.98). Other factors associated with smoking included younger age (OR = .97, 95% CI: .94-.99), problem drinking (OR = 1.07, 95% CI: 1.03-1.12), lower Body Mass Index (OR = .95, 95% CI: .90-.99), and being separated/widowed/divorced (OR = 2.24, 95% CI: 1.19-4.20). Further investigation is needed for better understanding about job-specific exposure patterns and their impact on cigarette smoking among operating engineers.
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Affiliation(s)
- OiSaeng Hong
- School of Nursing, University of California San Francisco, San Francisco, CA
| | - Sonia A. Duffy
- University of Michigan University of Michigan, Nursing, Otolaryngology, Psychiatry & VA Center for Clinical Management Research, VA Ann Arbor Healthcare System
| | - Seung Hee Choi
- School of Nursing, University of Michigan, Ann Arbor, MI
| | - Dal Lae Chin
- School of Nursing, University of California San Francisco, San Francisco, CA
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22
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McFarland MJ, Hayward MD, Brown D. I've Got You Under My Skin: Marital Biography and Biological Risk. JOURNAL OF MARRIAGE AND THE FAMILY 2013; 75:363-380. [PMID: 26078480 PMCID: PMC4465275 DOI: 10.1111/jomf.12015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Social relationships shape adult health in profound ways. This study informs our understanding of this association by investigating how the transitions, timing, and exposures to marriage are associated with types of biological risk presumed to serve as pathways to disease and disability. Drawing on the 2005 - 2006 National Social Health and Aging Project (N = 1,062), the authors evaluated how marital biography was associated with cardiovascular, metabolic, and chronic inflammation risk. The results showed that the effects of marital biography were highly sensitive to gender, the dimension of marital biography, and type of biological risk. For example, marital exposure was protective of cardiovascular risk for women, but not men, whereas an earlier age at first marriage had a pernicious effect on chronic inflammation among men, but not women. Health behaviors did not explain these associations. The implications of these findings are discussed as they pertain to under-the-skin risk processes and chronic morbidity.
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Affiliation(s)
- Michael J McFarland
- Center for Research on Child Wellbeing and Office of Population Research, 280 Wallace Hall, Princeton, NJ 08544 ( )
| | - Mark D Hayward
- Department of Sociology and Population Research Center, 110 Inner Campus Drive G1800, Austin, TX 78712-1699
| | - Dustin Brown
- Department of Sociology and Population Research Center, 110 Inner Campus Drive G1800, Austin, TX 78712-1699
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23
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Frisch M, Simonsen J. Marriage, cohabitation and mortality in Denmark: national cohort study of 6.5 million persons followed for up to three decades (1982-2011). Int J Epidemiol 2013; 42:559-78. [PMID: 23482379 DOI: 10.1093/ije/dyt024] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Living arrangements have changed markedly in recent decades, so we wanted to provide an up-to-date assessment of mortality as a function of marital status and cohabitation status in a complete population. METHODS We studied mortality in a national cohort of 6.5 million Danes followed for 122.5 million person-years during 1982-2011, using continuously updated individual-level information on living arrangements, socio-demographic covariates and causes of deaths. Hazard ratios (HRs) estimated relative mortality in categories of marital status, cohabitation status and combinations thereof. RESULTS HRs for overall mortality changed markedly over time, most notably for persons in same-sex marriage. In 2000-2011, opposite-sex married persons (reference, HR = 1) had consistently lower mortality than persons in other marital status categories in women (HRs 1.37-1.89) and men (HRs 1.37-1.66). Mortality was particularly high for same-sex married women (HR = 1.89), notably from suicide (HR = 6.40) and cancer (HR = 1.62), whereas rates for same-sex married men (HR = 1.38) were equal to or lower than those for unmarried, divorced and widowed men. Prior marriages (whether opposite-sex or same-sex) were associated with increased mortality in both women and men (HR = 1.16-1.45 per additional prior marriage). CONCLUSION Our study provides a detailed account of living arrangements and their associations with mortality over three decades, thus yielding accurate and statistically powerful analyses of public health relevance to countries with marriage and cohabitation patterns comparable to Denmark's. Of note, mortality among same-sex married men has declined markedly since the mid-1990s and is now at or below that of unmarried, divorced and widowed men, whereas same-sex married women emerge as the group of women with highest and, in recent years, even further increasing mortality.
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Affiliation(s)
- Morten Frisch
- Statens Serum Institut, Department of Epidemiology Research, DK-2300 Copenhagen S, Denmark.
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Lim HK, Ghazali SM, Kee CC, Lim KK, Chan YY, Teh HC, Yusoff AFM, Kaur G, Zain ZM, Mohamad MHN, Salleh S. Epidemiology of smoking among Malaysian adult males: prevalence and associated factors. BMC Public Health 2013; 13:8. [PMID: 23294728 PMCID: PMC3549287 DOI: 10.1186/1471-2458-13-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 01/04/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Three National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986-2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia. METHODS A cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income. RESULTS The prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5-47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21-30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67-2.60), primary school OR 1.95, 95% CI (1.65-2.30), secondary school OR 1.88, 95% CI (1.63-2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22-2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI ( 1.98-2.66; Chinese OR 1.23 95% CI (1.05-1.91), Other Bumis OR 1.75, 95% CI (1.46-2.10, others OR 1.48 95% CI (1.15-1.91), with Indian as the reference group), age group (18-20 years OR 2.36, 95% CI (1.90-2.94); 20-29 years OR 3.31 , 95% CI 2.82-3.89; 31-40 years OR 2.85 , 95% CI ( 2.47-3.28); 41-50 years OR 1.93, 95% CI (1.69-2.20) ; 51-60 years OR 1.32, 95% CI (1.15-1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12 , 95% CI ( 1.03-1.22)) urban as reference. CONCLUSION The prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status.
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Affiliation(s)
- Hock Kuang Lim
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Cheong Chee Kee
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Kuay Kuang Lim
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Ying Ying Chan
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Huey Chien Teh
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Ahmad Faudzi Mohd Yusoff
- Epidemiology and Biostatistic unit, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Gurpreet Kaur
- Proposal Development Section, Institute of Public Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Zarihah Mohd Zain
- Disease Control Division, Ministry of Health, 62590, Putrajaya, Malaysia
| | - Mohamad Haniki Nik Mohamad
- Pharmacy Practice Department, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, 25200, Kuantan, Pahang, Malaysia
| | - Sallehuddin Salleh
- Health Division, Kuala Lumpur City Hall, Jalan Raja Laut, 50350, Kuala Lumpur, Malaysia
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Yim HJ, Park HA, Kang JH, Kim KW, Cho YG, Hur YI, Choi OJE. Marital Status and Health Behavior in Middle-aged Korean Adults. Korean J Fam Med 2012; 33:390-7. [PMID: 23267425 PMCID: PMC3526722 DOI: 10.4082/kjfm.2012.33.6.390] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 10/20/2012] [Indexed: 11/08/2022] Open
Abstract
Background Marital status is as an important sociodemographic variable for health studies. We assessed the association between marital status and health behavior in middle-aged Korean adults. Methods This is a cross-sectional study of 2,522 Korean middle-aged adults (1,049 men, 1,473 women) from the 2010 Korean National Health and Nutrition Examination Survey. The subjects were classified as living with a partner or living without a partner (never married, separated, widowed, and divorced). We assessed the relationship between marital status and five health behaviors (smoking, high-risk alcohol intake, regular exercise, regular breakfast consumption, and undergoing periodic health screening). Results Age, income level, educational level, and occupational classification were all significantly associated with marital status. The risk of undergoing health screening (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.32 to 0.90) and having regular breakfast (OR, 0.50; 95% CI, 0.27 to 0.92) were significantly lower in men living without a partner than with a partner. Women living without a partner had a higher smoking risk (OR, 2.27; 95% CI, 1.09 to 4.73) and a higher risk of high-risk alcohol consumption (OR, 5.33; 95% CI, 1.65 to 17.24) than their counterparts. Conclusion Korean middle-aged adults living with partners are more likely to have healthier behavior than living without a partner. The association between marital status and health behaviors differed by sex.
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Affiliation(s)
- Hyun Ji Yim
- Department of Family Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Norberg M, Malmberg G, Ng N, Broström G. Who is using snus? - Time trends, socioeconomic and geographic characteristics of snus users in the ageing Swedish population. BMC Public Health 2011; 11:929. [PMID: 22169061 PMCID: PMC3267833 DOI: 10.1186/1471-2458-11-929] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 12/14/2011] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The prevalence of smoking in Sweden has decreased in recent decades, and is now among the lowest in the world. During the same period, the use of Swedish moist oral snuff, a smokeless tobacco called snus, has increased. Few studies have evaluated time trends of the socioeconomic and geographic characteristics of snus users in Sweden. This paper contributes to filling that gap. METHODS This study utilized the Linnaeus Database, which links national registers with comprehensive individual data on socioeconomic status (SES) to health data from a large ongoing health survey, the Västerbotten Intervention Programme (VIP). The VIP targets the entire middle-aged population of Västerbotten county at ages 40, 50 and 60 years with yearly cross-sectional surveys including self-reported data on tobacco habits. Time trends of snus use among 92,563 VIP-participants across different areas of residence and smoking groups were investigated graphically. Logistic regression was performed to estimate the associations between SES and geographical variables and current use versus non-use of snus. RESULTS Overall, in parallel to decreasing smoking, the increasing trend of snus use in this middle-aged population continues, particularly in 40-year-olds. In both genders, the highest prevalence of snus use was observed among previous smokers. The prevalence of snus use also increased over time among smokers, and was consistently higher compared to those who had never smoked. Among males - both those who had never smoked and previous smokers - low education (OR 1.21, 95%CI 1.06-1.40 and OR 1.28, 95%CI 1.14-1.43), living alone (OR 1.16, 95%CI 1.07-1.27 and OR 1.13, 95%ci 1.04-1.23), low income and living in rural areas was associated with using snus, while this was not seen among male current smokers. Among women, living alone was associated with using snus irrespective of smoking habits. Among female smokers, the OR for snus use increased with higher education. CONCLUSIONS A disadvantaged social profile and also higher prevalence in rural areas is observed among male snus users who had never smoked or were previous smokers. Among male smokers there was no association between SES and use of snus. The prevalence of snus use among women is increasing, but is still considerably lower than that of men. The association between snus and SES characteristics is less pronounced among women, although snus is clearly linked to living alone. These patterns should be taken into consideration in tobacco control policies.
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Affiliation(s)
- Margareta Norberg
- Centre for Population Studies/Ageing and Living Conditions Programme, Umeå University, Umeå SE-901 87, Sweden.
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Pahl K, Brook JS, Koppel J, Lee JY. Unexpected benefits: pathways from smoking restrictions in the home to psychological well-being and distress among urban Black and Puerto Rican Americans. Nicotine Tob Res 2011; 13:706-13. [PMID: 21498429 PMCID: PMC3150690 DOI: 10.1093/ntr/ntr062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 03/10/2011] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study examined the pathways from smoking policies in the home (no ban, partial ban, and total ban on smoking) to psychological well-being (e.g., self-esteem) and psychological symptoms (e.g., depressive symptoms) as mediated by a healthy lifestyle (engaging in exercise, eating healthful foods, and sleeping enough) and cigarette smoking among a sample of urban Black and Puerto Rican Americans. METHODS Questionnaire data were collected from 816 participants (mean age = 32 years). Structural equation modeling (SEM) was employed to examine the pathways of restrictions on smoking in the home to a healthy lifestyle, cigarette smoking, psychological well-being, and psychological distress. RESULTS The SEM showed mediational pathways linking higher levels of restrictions on smoking in the home with a healthy lifestyle, which in turn was related negatively to psychological distress and positively to psychological well-being. Higher levels of restrictions on smoking in the home were also related inversely to cigarette smoking, which was related positively to psychological distress and negatively to psychological well-being. CONCLUSIONS Findings show that higher levels of restrictions on smoking in the home are associated with a healthier lifestyle and less cigarette smoking, which in turn are associated with better psychological functioning. Greater restrictions on smoking in the home may thus support positive lifestyle choices, including exercise and nutrition, as well as psychological functioning.
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Affiliation(s)
- Kerstin Pahl
- Department of Psychiatry, New York University School of Medicine, 215 Lexington Avenue, New York, NY 10016, USA.
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Thompson AB, Moon-Howard J, Messeri PA. Smoking cessation advantage among adult initiators: does it apply to black women? Nicotine Tob Res 2011; 13:15-21. [PMID: 21078832 PMCID: PMC6383617 DOI: 10.1093/ntr/ntq200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 10/18/2010] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Smokers who initiate as adults are more likely to quit than those who initiate as adolescents. Black women are more likely than White women to initiate smoking in adulthood and are less likely to quit. There is a paucity of research examining whether the smoking cessation advantage among adult initiators applies to Black women. The study objective is to examine race differences in the effect of developmental stage of smoking initiation on number of years until cessation among Black and White women. METHODS Data were extracted from the National Longitudinal Survey of Young Women, a national cohort of women between the ages of 49 and 61 years in 2003. The analytic sample comprised 1,008 White women and 271 Black women with a history of smoking. Survival analysis procedures were utilized to address the study objective. RESULTS Racial disparities in smoking cessation were most evident among women who initiated smoking as adults. White young adult initiators had a 31% increased hazard of smoking cessation advantage (adjusted hazards ratio [HR]: 1.31, 95% CI: 1.04-1.65) over adolescent initiators, whereas Black young adult initiators had no smoking cessation advantage (adjusted HR: 0.85, CI: 95% 0.55-1.30) over adolescent initiators. CONCLUSIONS Prior observations that smoking initiation in adulthood is associated with high rates of cessation do not apply to black women. To contribute to the reduction of disparities in women's cessation efforts to prevent initiation should target young adult women, particularly Black young adult women.
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Affiliation(s)
- Azure B Thompson
- Department of Sociomedical Sciences Columbia University Mailman School of Public Health, New York, NY, USA.
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Rod NH, Hansen J, Schernhammer E, Ritz B. Major life events and risk of Parkinson's disease. Mov Disord 2010; 25:1639-45. [PMID: 20602449 DOI: 10.1002/mds.22850] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Major life events such as divorce, death of a spouse or a child, or long-term unemployment are stressful to most people and animal models have suggested a link between stress and onset of parkinsonian symptoms. In a large case-control study based on nationwide registries, we aim to address whether major life events are risk factors for Parkinson's disease. Between 1986 and 2006, we identified 13,695 patients with a (PD) primary diagnosis of PD in the Danish National Hospital Register. Each case was frequency matched by age and gender to five population controls. Information on major life events before onset of PD was ascertained from national registries. Among men, number of life events was associated with risk of Parkinson's disease in an inverse dose-response manner (P < 0.0001). Compared to no events, three or more events were associated with a 42% lower risk of PD (OR = 0.58; 95 % CI: 0.34-0.99). Life events were not associated with PD in women. In contrast, a higher risk of PD was observed among women who had never been married (1.16; 1.04-1.29) and among men (1.47; 1.18-1.82) and women (1.30; 1.05-1.61) who have never been employees. The lower risk of Parkinson's disease among men who had experienced life events was unexpected but might suggest a general "risk avoidance behavior" in Parkinson's patients.
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Affiliation(s)
- Naja Hulvej Rod
- Institute of Public Health, University of Copenhagen, Department of Social Medicine, Copenhagen, Denmark.
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Hawkins J, Hollingworth W, Campbell R. Long-term smoking relapse: a study using the british household panel survey. Nicotine Tob Res 2010; 12:1228-35. [PMID: 21036960 DOI: 10.1093/ntr/ntq175] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is limited population-based evidence on long-term smoking relapse rates after 1 year of abstinence. We estimate the incidence of relapse and evaluate demographic, health, socioeconomic characteristics, and episodic events associated with an increased probability of relapse. METHODS Smoking relapse is studied using a subsample of individuals in the annual British Household Panel Survey, between 1991 and 2006, who reported not being a smoker for at least 1 year (two consecutive surveys) after previously reporting smoking (n = 1,578). A random-effects panel logit regression was used to examine the association between smoking relapse and length of abstinence, demographic, socioeconomic, and health variables. RESULTS Data were available on individuals for a mean of 5.2 years after the initial 1-year smoking abstinence. We estimated that 37.1% (34.0%-40.5%; 95% CI) of the sample would relapse within 10 years. Increased length of abstinence, increased age, being married, being educated to degree level, and a high frequency of General Practitioner (GP) visits were significantly associated with a lower risk of relapse. Conversely, higher relapse rates were significantly associated with mental health problems and having a partner who started smoking. CONCLUSIONS A significant proportion of smokers relapse after more than 1 year of abstinence. This study sheds light on factors associated with long-term relapse. This can form the basis for designing public health interventions to prolong abstinence and targeting interventions at former smokers at the highest risk of relapse.
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Affiliation(s)
- James Hawkins
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
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Factors influencing gender differences in smoking and their separate contributions: Evidence from South Korea. Soc Sci Med 2010; 70:1966-1973. [DOI: 10.1016/j.socscimed.2010.02.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2009] [Revised: 01/28/2010] [Accepted: 02/24/2010] [Indexed: 11/19/2022]
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Lee S, Guo WJ, Tsang A, Huang YQ, He YL, Kessler RC. Prevalence and correlates of active and ever-smokers in metropolitan China. Addict Behav 2009; 34:969-72. [PMID: 19493629 DOI: 10.1016/j.addbeh.2009.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Revised: 04/15/2009] [Accepted: 05/11/2009] [Indexed: 11/20/2022]
Abstract
This study investigated the prevalence and demographic correlates of active and ever-smokers in Beijing and Shanghai. Using a multi-stage household probability sampling method, 5201 participants aged 18-70 underwent face-to-face interviews using the Composite International Diagnostic Interview. 67.1% and 55.5% of male and 7.1% and 5.5% of female respondents were ever-smokers and active smokers respectively. Quitting was less common by proportion among those no longer married or never-married, middle-aged or working adults. After adjusting for other sociodemographic factors, the oldest age-group (>54 years) showed a significantly negative association with active smoking while those no longer married had significantly positive association with active smoking, among ever-smokers. Although the high prevalence of male smoking in Beijing and Shanghai was expected, the prevalence of female smoking was significantly higher than those found in previous surveys. This pattern of more female smoking not accompanied by an obvious decrease in male smoking defies the expectation of an orderly transition of smoking patterns and may foreshadow smoking patterns in other parts of China.
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Affiliation(s)
- Sing Lee
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, PR China.
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The influence of housing tenure and marital status on smoking in South Korea. Health Policy 2009; 94:101-10. [PMID: 19783317 DOI: 10.1016/j.healthpol.2009.08.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 08/24/2009] [Accepted: 08/30/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to identify the most influential socioeconomic indicator of smoking in South Korea. METHODS This study analyzed a nationally representative sample (6141 men and 7133 women aged 20-65) from the 2001 and 2005 Korea National Health and Nutrition Surveys. Weighted estimates were computed, adjusting for a complex survey design using "surveyfreq" and "surveylogistic" procedures of SAS 9.1 software. RESULTS The adjusted OR for smoking in renters compared to homeowners was 1.50 (95% CI: 1.32-1.71) in men and 3.21 (95% CI: 2.41-4.27) in women, and larger in the older than younger groups. For non-married versus married individuals, the OR was 1.37 (95% CI: 1.19-1.59) in men and 3.25 (95% CI: 2.48-4.25) in women; the OR in non-married renters compared married homeowners was 1.79 (95% CI: 1.45-2.22) in men and 10.63 (95% CI: 7.31-15.45) in women. CONCLUSION Housing tenure was a strong predictor of smoking in South Korea and its significance was very pronounced in non-married individuals. Housing policies to encourage homeownership could be effective in reducing smoking in countries such as China, India, and Vietnam where house ownership is regarded as the ultimate financial safeguard, there are numerous, and traditional attitudes toward marriage are undergoing transition.
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Frisch M, Brønnum-Hansen H. Mortality among men and women in same-sex marriage: a national cohort study of 8333 Danes. Am J Public Health 2008; 99:133-7. [PMID: 19008504 DOI: 10.2105/ajph.2008.133801] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We studied overall mortality in a demographically defined, complete cohort of gay men and lesbians to address recent claims of markedly shorter life spans among homosexual persons. METHODS We calculated standardized mortality ratios (SMRs) starting 1 year after the date of same-sex marriage for 4914 men and 3419 women in Denmark who married a same-sex partner between 1989 and 2004. RESULTS Mortality was markedly increased in the first decade after same-sex marriage for men who married between 1989 and 1995 (SMR=2.25; 95% confidence interval [CI]=2.01, 2.50), but much less so for men who married after 1995, when efficient HIV/AIDS therapies were available (SMR=1.33; 95% CI=1.04, 1.68). For women who married their same-sex partner between 1989 and 2004, mortality was 34% higher than was mortality in the general female population (SMR=1.34; 95% CI=1.09, 1.63). For women, and for men marrying after 1995, the significant excess mortality was limited to the period 1 to 3 years after the marriage. CONCLUSIONS Despite recent marked reduction in mortality among gay men, Danish men and women in same-sex marriages still have mortality rates that exceed those of the general population. The excess mortality is restricted to the first few years after a marriage, presumably reflecting preexisting illness at the time of marriage. Although further study is needed, the claims of drastically increased overall mortality in gay men and lesbians appear unjustified.
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Affiliation(s)
- Morten Frisch
- Department of Epidemiology Research, Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen S, Denmark.
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Igna CV, Julkunen J, Vanhanen H, Keskivaara P, Verkasalo M. Depressive symptoms and serum lipid fractions in middle-aged men: physiologic and health behavior links. Psychosom Med 2008; 70:960-6. [PMID: 18981271 DOI: 10.1097/psy.0b013e318189a942] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To investigate alternative hypothetical models that could clarify the relationship between depressive symptoms and serum cholesterol fractions, i.e., high-density lipoprotein (HDL) and low-density lipoprotein (LDL). It was hypothesized that the impact of the depressive symptoms on cholesterol fractions is mediated through health behavior and body mass index, and at the same time there would be a direct link from depression to cholesterol. METHODS The study sample consisted of 893 middle-age men who participated in a trial aimed at preventing the metabolic syndrome, Type 2 diabetes and cardiovascular diseases. Serum cholesterol was measured by the enzymatic method. Participants completed self-report questionnaires assessing health behavior and depressive symptoms. RESULTS Depressive symptoms consistently correlated statistically significantly with adverse lifestyle factors and, as hypothesized, positively with HDL. Path analyses supported the parallel existence of two main pathways: from depression through adverse health behavior to unfavorable cholesterol fraction balance, and a direct physiological link indicative of beneficial effect of depression on cholesterol levels. CONCLUSIONS It is concluded that, among a sample of men, depressive symptoms are linked to cholesterol fractions through two different pathways. An adverse relationship of depression with serum lipids HDL-LDL balance is partly mediated through harmful health behaviors. At the same time, the results indicate a direct, physiological link between depressive symptoms and cholesterol that has a beneficial influence on the HDL-LDL balance.
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Life-course socioeconomic environment and health risk behaviours. A multilevel small-area analysis of young-old persons in an urban neighbourhood in Lausanne, Switzerland. Health Place 2008; 15:273-83. [PMID: 18614388 DOI: 10.1016/j.healthplace.2008.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2007] [Revised: 05/26/2008] [Accepted: 05/28/2008] [Indexed: 11/22/2022]
Abstract
With a life expectancy at the age of 65 of around 20 years, damaging health risk behaviours of young-old adults have become a target for preventive actions. Such risk factors necessitate an accurate understanding of the present and past socioeconomic conditions associated with health risk behaviours. The aim of our study is to assess the impact of certain life events as well as economic and environmental factors on health risk behaviours. We included 1309 participants of the Lausanne Cohort Lc65+ aged 65-70 years and employed logistic regression analyses, with individuals nested within areas. The results illustrate the influences of socioeconomic factors from childhood to young-old age. Life experiences in adulthood and economic resources in young-old age are both associated with unfavourable health behaviours. Neighbourhood is a modest determinant as well, particularly regarding alcohol consumption. Therefore, prevention against health risk behaviours should focus on population subgroups defined on the basis of their socioeconomic and living contexts.
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Villalonga-Olives E, Valderas JM, Palacio-Vieira JA, Herdman M, Rajmil L, Alonso J. The adaptation into Spanish of the Coddington Life Events Scales (CLES). Qual Life Res 2008; 17:447-52. [PMID: 18320350 DOI: 10.1007/s11136-008-9320-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 02/10/2008] [Indexed: 11/26/2022]
Abstract
AIMS To obtain a conceptually and psychometrically equivalent Spanish version of the Coddington Life Events Scales (CLES) for children and adolescents and to test their psychometric properties. METHODS Forward and backward translations were performed. Comprehension, acceptability, and alternative translations were tested in focus groups and semi-structured interviews. An expert panel and the copyright holders of the original version were actively involved. Test-retest reliability [Intraclass Correlation Coefficient (ICC)] was assessed by administering the questionnaire on two occasions 3 months apart to children aged 12-14 years (n = 30). Construct validity was assessed by comparing children's responses with those of their parents (n = 19). The methods replicated those of the validation of the original version. RESULTS Of the 53 CLES items translated, ten were found to be difficult to understand. Following back-translation, seven items were modified and a final version was obtained. Test-retest ICC reliability for total scores was 0.63. The ICC between children and parents was 0.42. Both results were very similar to those reported for the original version. CONCLUSIONS These preliminary findings suggest that the Spanish version of the CLES is understandable and acceptable and that it is similar to the original in terms of validity and reliability. Although further validation is needed, it is recommended for use in research settings in Spain.
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Ferketich AK, Wee AG, Shultz J, Wewers ME. Smokeless tobacco use and salivary cotinine concentration. Addict Behav 2007; 32:2953-62. [PMID: 17604914 PMCID: PMC2262158 DOI: 10.1016/j.addbeh.2007.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 04/23/2007] [Accepted: 06/04/2007] [Indexed: 11/19/2022]
Abstract
The objective of the current study was to examine demographic, tobacco-related, and psychosocial factors associated with cotinine concentration in a group of 256 male smokeless tobacco (ST) users living in the Ohio Appalachian region. Participants completed a survey that included questions on: 1) current and past tobacco use behaviors; 2) demographics; 3) tobacco dependence; 4) decisional balance; 5) health behaviors; and 6) perceived stress and depressive symptoms. Saliva samples were obtained for measurement of cotinine. The variables related to salivary cotinine concentration in the multiple regression model were age, marital status, occupation, quit attempts, years of ST use, and tobacco dependence score (adjusted R(2)=0.24). Among the 199 snuff only users, cotinine concentration was positively related to age, being divorced/widowed/separated, no quit attempts in the previous year, dependence score, and brand of snuff (adjusted R(2)=0.29). This is one of the largest studies to examine influences beyond topography on cotinine concentration in a group of rural ST users. These findings suggest that smokeless tobacco users and smokers share some similarities with respect to tobacco dependence.
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Affiliation(s)
- Amy K Ferketich
- Division of Epidemiology, The Ohio State University College of Public Health, B-209 Starling-Loving Hall, 320 West 10th Avenue, Columbus, OH 43210, USA.
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Abstract
Few studies have examined the influence of marriage on health-related behavior in Asian populations. The present study examined the effect of marital status on smoking in Korea. Data from two rounds of a nationally representative survey (1999 and 2003) were analyzed (57,246 women and 52,769 men). Marital status-specific prevalence ratios for smoking were estimated using log binomial regression after adjusting for age, survey year, occupation and education level. Smoking prevalence declined with age for men, but rose for women. Smoking rates were higher for unmarried men and women compared to their married counterparts. However, the gap in smoking rates between unmarried and married women (especially younger women <45 years) was much greater than the gap between unmarried and married men. The study found that marital status had a stronger protective influence on smoking in women than men, which contrasts with the gender pattern reported previously in western studies. The findings suggest the influence of a culture which discourages married women from smoking, and "liberates" divorced women from cultural sanctions against smoking in marriage.
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Martinez E, Kaplan CP, Guil V, Gregorich SE, Mejia R, J Pérez-Stable E. Smoking Behavior and Demographic Risk Factors in Argentina: A Population-Based Survey. ACTA ACUST UNITED AC 2006; 2:187-197. [PMID: 18037987 DOI: 10.1016/j.precon.2007.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND: Demographic and socioeconomic factors associated with smoking behavior were evaluated in a nationwide household survey in Argentina to describe the status of the tobacco epidemic. METHODS: Face-to-face interviews with adults, age 20 and older, assessed smoking status, frequency, and age of initiation. Multivariate logistic regression was used to compare social and demographic characteristics. RESULTS: Of the 43,863 participants, 38% of men and 24% of women were current smokers, and 20% of current smokers smoked occasionally. For older men and women, smoking was less prevalent and their probability of quitting higher. Men with more than high school education were less likely to be current smokers. Rates for women did not differ by education. CONCLUSIONS: The lower smoking rates among men with more education suggest that Argentina has begun to transition to the next stage of the tobacco epidemic. Tobacco control policy must direct efforts to change smoking behavior.
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Affiliation(s)
- Eugenio Martinez
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco
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