Early-Life Adversities and Recalcitrant Smoking in Midlife: An Examination of Gender and Life-Course Pathways

Prevalence of Paternal Prenatal Depression and Its Associated Factors in Saudi Arabia

Background

Paternal prenatal depression affects not only the fathers but also their spouses and children's future lives. Many socioeconomic and cultural factors affect the probability of paternal depression. Little is known about the prevalence of and factors associated with paternal prenatal depression in the Middle East.

Aim

To estimate the prevalence of paternal prenatal depression among fathers visiting a tertiary university hospital, as well as to determine the factors associated with paternal prenatal depression within study participants.

Methods

This analytical cross-sectional study included 442 fathers whose wives were pregnant and were undergoing regular assessments at antenatal clinics in a tertiary university hospital in Riyadh, Saudi Arabia. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess paternal depression. Bivariate and multivariate analyses were performed.

Results

The prevalence of paternal prenatal depression was 26.9%. It was correlated with smoking (odds ratio (OR)=1.8, p=0.006), maternal depression (OR=4.59, p<0.001), and experiencing isolation (OR=5.34, p<0.001). The odds of paternal prenatal depression decreased with social support from friends and family (OR=0.227 and 0.133, respectively) and p<0.001.

Discussion and Conclusion

Paternal prenatal depression was prevalent within the study participants. Notably, experiences of isolation and maternal depression emerged as prominent factors that were significantly associated with the manifestation of paternal depression. Consequently, it becomes imperative to implement systematic depression screenings for expectant fathers and to meticulously consider the array of the factors associated with paternal depression.

Social Participation and Persistent Smoking Among Older Chinese With Smoking-Related Morbidity

OBJECTIVES

Chronic diseases are common in midlife and old age and smoking can pose more health and longevity challenges for older people with chronic illnesses. In China where smoking is highly prevalent, older adults are likely to continue smoking even after developing severe chronic diseases. We examined the national prevalence of persistent smoking among older adults. We also investigated the sociodemographic characteristics of persistent smoking among ever-smokers with chronic diseases and its association with social participation (of various types).

METHODS

We used data from a nationally representative sample of older adults aged 45-80 in the China Health and Retirement Longitudinal Study (2011-2018). Multinomial logistic and multilevel logistic models were fitted.

RESULTS

The national prevalence of persistent smoking was around 24% of older men and 3% of older women. Among those with a history of smoking and chronic illness, younger, nonmarried/partnered, nonretired, or less educated individuals are more likely to continue smoking. Social participation is significantly associated with persistent smoking among those with chronic diseases, but the association differs across different forms of activities. Although the most popular but sedentary activities in China (playing Mahjong, chess, or cards) are associated with an elevated risk of persistent smoking, physical social activities (community-organized dancing, fitness, and qigong) are associated with a reduced risk of persistent smoking.

DISCUSSION

Given the enormous burden of persistent smoking on individuals and society, public smoking cessation inventions should address sociocultural factors of persistent smoking and target older adults who participate in specific social activities.

Gender, Tobacco Control Policies, and Persistent Smoking Among Older Adults: A Longitudinal Analysis of 11 European Countries

INTRODUCTION

Little is known about sociodemographic and macro-level predictors of persistent smoking when one has developed a health condition that is likely caused by smoking.

AIMS AND METHODS

We investigate the impact of gender, education, and tobacco control policies (TCPs) on persistent smoking among older Europeans. Respondents (aged 50 +) with a smoking history and at least one smoking-related health condition were pooled from the Survey of Health, Aging and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA) from four waves from 2004 to 2013. We fitted gender-specific logistic regression models with two-way fixed effects (country and year) and tested interaction terms between gender, education, and TCPs.

RESULTS

Although women are less likely to smoke than men, they were more likely to smoke persistently. The effects of education and general TCPs on persistent smoking were significant for women only. Compared to women with low levels of education, those with moderate education (odds ratio [OR] = .63; .49-.82) and high education (OR = .57; .34-.98) are less likely to be persistent smokers. TCPs are associated with a reduced risk of women's persistent smoking (OR = .70; .51-.95) and the association is stronger for those having less education.

CONCLUSIONS

Older women, particularly those with low levels of education, are vulnerable to persistent smoking. TCPs might be effective in reducing persistent smoking for older women, with greater effects for less-educated women. Future studies are needed to understand mechanisms that explain gender differences in responsiveness to TCPs.

IMPLICATIONS

Persistent smoking is a particularly harmful smoking behavior as it is associated with greater risks of comorbidity and mortality. By employing the framework of the multilevel social determinants of health, this study examined the behavior of persistent smoking among older adults in European countries. Women, especially women with low levels of education are vulnerable to persistent smoking. Moreover, TCPs, in general, are significantly related to a reduction in persistent smoking among older women only and the negative association is stronger for those having less education, indicating gender and socioeconomic differences in responsiveness to TCPs.