Better Off Alone Than With a Smoker: The Influence of Partner's Smoking Behavior in Later Life

Cohabitation with a smoker and efficacy of cessation programmes: the mediating role of the theory of planned behaviour

OBJECTIVE

The present research sought to examine whether cohabitation with a smoker undermines smoking cessation among people engaged in a cessation programme and whether the components of the Theory of Planned Behaviour (TPB) act as mediating mechanisms.

DESIGN

A prospective longitudinal study with online questionnaires was conducted among smokers living in Switzerland who enrolled in a 6-months smoking cessation programme.

MAIN OUTCOME MEASURES

Cohabitation with a smoker and the TPB constructs were assessed 10 days after the start of the programme (T1; N = 820). Smoking abstinence was measured at T1, and at 3-months (T2; N = 624) and 6-months follow-ups (T3; N = 354).

RESULTS

Results showed that living with a smoker decreased the odds that smokers remained abstinent throughout the cessation programme. Furthermore, we found that cohabitation was negatively associated with subjective norm. Afterwards, subjective norm predicted intention to maintain smoking cessation, which, in turn, predicted smoking abstinence. Such mediation effects persisted at each time point.

CONCLUSION

The present research provided evidence that living with other smokers at home can lead to greater risks of relapsing among people engaged in a cessation programme. We discussed the role of smoking-related norms in the efficacy of cessation interventions.

Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2022.2041638 .

Partners in Health: Investigating Social Genetic Effects Among Married and Cohabiting Couples

Partners resemble each other in health behaviors and outcomes such as alcohol use, smoking, physical activity, and obesity. While this is consistent with social contagion theory suggesting partner influence, it is notoriously difficult to establish causality because of assortative mating and contextual confounding. We offer a novel approach to studying social contagion in health in long-term partnerships by combining genetic data of both partners in married/cohabiting couples with longitudinal data on their health behaviors and outcomes. We examine the influence of the partner's genetic predisposition for three health outcomes and behaviors (BMI, smoking, and drinking) among married/cohabiting couples. We use longitudinal data from the Health and Retirement Study and the English Longitudinal Study of Ageing with data on health outcomes and genotypes for both partners. Results show that changes over time in BMI, smoking, and drinking depend on the partner's genetic predispositions to these traits. These findings underline the importance of people's social surroundings for their health and highlight the potential of targeting health interventions at couples.

Health behaviors, obesity, and marital status among cancer survivors: a MEPS study

PURPOSE

Promoting positive health behaviors helps improve cancer survivors' health outcomes during survivorship; however, little is known about whether health behaviors differ by marital status. The purpose is to examine whether health behaviors and obesity among cancer survivors vary by marital status and whether the type of cancer and sociodemographic factors influence the relationship.

METHODS

We examined smoking, physical activity, and body mass index (BMI) among 1880 individuals diagnosed with prostate, breast, or colon cancer who were identified from the 2011-2017 Medical Expenditure Panel Survey (MEPS). We used Rao-Scott design-adjusted chi-square tests and weighted multivariable logistic regressions to achieve the research aims.

RESULTS

Current smoking behavior and BMI were significantly related to marital status. Survivors who had never married were the most likely to be current smokers across all cancer types. Married survivors were the most likely to be overweight or obese, while widowed survivors were the most likely to have a normal weight. The relationship between BMI and marital status varied by cancer type. Widowed colon cancer survivors were least likely to be overweight or obese; divorced/separated colon cancer survivors were most likely to be obese or overweight. Health behavior disparities were found among cancer survivors of different age, sex, race, and levels of education and income.

CONCLUSIONS

There were relationships between marital status, health behaviors, and obesity among cancer survivors.

IMPLICATIONS FOR CANCER SURVIVORS

Our results suggested that relationship status and sociodemographic factors need to be considered in tailoring interventions to promote health behaviors among cancer survivors.

Long-term follow-up of tobacco cessation intervention in a dental setting: A randomized trial

Aims and Objectives

Tobacco dependence is widely prevalent and a harmful chronic disorder. Achieving long-term tobacco abstinence is an important public health goal. This study aims to assess the long-term effectiveness of moderate-intensity treatment for tobacco cessation in the dental clinic setting.

Materials and Methods

Out of 1206 subjects registered to the Tobacco cessation clinic (TCC) during this time period, only 999 of them completed the 1-year follow-up period. The mean age was 45.9 ± 9 years. Six hundred and three (60.3%) of these subjects were male and 396 (39.6%) of them were females. Five hundred and fifty-eight (55.8%) used smoking tobacco and 441 (44.1%) used smokeless tobacco. Patients received tailored behavioral counseling, educational material, and pharmacotherapy consisting of nicotine replacement therapy (NRT) and\or NON-NRT. Patients were monitored by phone or clinic visits for 11 months.

Results

Outcomes assessed were complete abstinence, harm reduction (>50% reduction), no change and lost to follow-up. At the end of 12 months the tobacco quit rate was180 (18%), tobacco reduction >50% was 342 (34.2%), no change 415 (41.5%) and relapse 62 (6.2%).

Conclusions

Our study has identified adequate quit-rates in a cohort of dental patients attending a hospital-based TCC.

COVID-19 precautionary behaviors and vaccine acceptance among older individuals: The role of close kin

The family plays a central role in shaping health behaviors of its members through social control and support mechanisms. We investigate whether and to what extent close kin (i.e., partner and children) matter for older people in taking on precautionary behaviors (e.g., wearing a mask) and vaccination during the COVID-19 pandemic in Europe. Drawing on data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we combine its Corona Surveys (June to September 2020 and June to August 2021) with pre-COVID information (October 2019 to March 2020). We find that having close kin (especially a partner) is associated with a higher probability of both adopting precautionary behaviors and accepting a COVID-19 vaccine. Results are robust to controlling for other potential drivers of precautionary behaviors and vaccine acceptance and to accounting for coresidence with kin. Our findings suggest that policymakers and practitioners may differently address kinless individuals when promoting public policy measures.

Educational gradient in social network changes at disease diagnosis

This study examines the educational gradient in social network changes following the diagnosis of new chronic diseases. Using a representative sample of the US older population, the author shows that the network size and amount of health-related discussion with social network members increased only for older adults with a bachelor's degree. Tie-level analyses reveal that such increase is from the activation of health discussion with the existing social network members, but not from the changes in discussion partners. These results suggest that heterogeneous temporal dynamics in social networks may be one mechanism that shapes diverging health trajectories in later life.

Smoking Habits and Workplace Health Promotion among University Students in Southern Italy: A Cross-Sectional Pilot Investigation

The study aimed to investigate the tobacco smoking prevalence, habits and awareness among a cohort of healthcare students from a university hospital in southern Italy and the associations with socio-demographic determinants. A secondary outcome was to estimate the educational needs to receive information on smoking-related risk factors. Five hundred and forty-nine students completed a self-administered questionnaire (180 male and 369 female, average age 25 yo, ±5.9 SD), enrolled from October 2018 to November 2019 at the University of Naples 'Luigi Vanvitelli', and the collected data were analysed by descriptive and inferential statistical analysis. The sample's prevalence of current smokers was 25.3%, without a significant sex difference. The multiple logistic regression model showed the link between smoking habits and alcoholic beverage consumption (p < 0.001) and living with smokers (p = 0.003). The enrolled cohort does not seem to need more information about the risks of cigarette smoking (p = 0.028). The data analysis and the comparison with the current literature allowed the authors to hypothesise a training model to be adopted within a workplace health promotion programme managed by an occupational physician. This model included targeted training for smoking dissuasion, focusing on sex and gender, cohabitant's influence, and combined addiction management. Further research will focus on the effectiveness of these proposed models.

Self- and other-efficacy are related to current smoking during a quit attempt: a daily diary study in single-smoking couples

OBJECTIVE

Self-efficacy is an important predictor of smoking cessation. Partners' confidence in the other partner's health behaviour, or other-efficacy, seems predictive of beneficial health outcomes, but has not yet been examined with respect to smoking cessation. This diary study examined whether daily fluctuations and general levels of non-smoking partners' other-efficacy relates to same- and next-day smoking, over and above smokers' own self-efficacy.

DESIGN

Smokers and their non-smoking partners (169 couples) participated in an intensive longitudinal study over 21 days with end-of-day diaries, starting on the day of planned cessation.

MAIN OUTCOME MEASURES

Smoking abstinence.

RESULTS

Smokers who had higher self-efficacy than other smokers in the sample had a lower probability of smoking on a given day, regardless of smoking the previous day. On days with higher self-efficacy and other-efficacy than usual, smokers had a lower probability of smoking.

CONCLUSION

To start the quit attempt with high self-efficacy, and maintain it throughout the quit attempt seems important for successful abstinence, as this might help to overcome a lapse. This is the first study to show that other-efficacy is related to smoking behaviour. However, more research is needed regarding the temporal order of smoking and efficacy, from both smokers and spouses.

Factors motivating smoking cessation: a cross-sectional study in a lower-middle-income country

INTRODUCTION

Only one-quarter of smokers in Pakistan attempt to quit smoking, and less than 3% are successful. In the absence of any literature from the country, this study aimed to explore factors motivating and strategies employed in successful smoking cessation attempts in Pakistan, a lower-middle-income country.

METHODS

A survey was carried out in Karachi, Pakistan, amongst adult (≥ 18 years) former smokers (individuals who had smoked ≥100 cigarettes in their lifetime but who had successfully quit smoking for > 1 month at the time of survey). Multivariable logistic regression, with number of quit attempts (single vs. multiple) as the dependent variable, was performed while adjusting for age, sex, monthly family income, years smoked, cigarettes/day before quitting, and having suffered from a smoking-related health problem.

RESULTS

Out of 330 former smokers, 50.3% quit successfully on their first attempt with 62.1% quitting "cold turkey". Only 10.9% used a cessation aid (most commonly nicotine replacement therapy: 8.2%). Motivations for quitting included self-health (74.5%), promptings by one's family (43%), and family's health (14.8%). Other social pressures included peer-pressure to quit smoking (31.2%) and social avoidance by non-smokers (22.7%). Successful smoking cessation on one's first attempt was associated with being married (OR: 4.47 [95% CI: 2.32-8.61]), employing an abrupt cessation mode of quitting (4.12 [2.48-6.84]), and telling oneself that one has the willpower to quit (1.68 [1.04-2.71]).

CONCLUSION

In Pakistan, smoking cessation is motivated by concern for self-health and family's health, family's support, and social pressures. Our results lay a comprehensive foundation for the development of smoking-cessation interventions tailored to the population of the country.

IMPLICATIONS

Little is known about the patterns and strategies employed by smokers who are attempting to quit smoking, especially in lower-middle-income countries like Pakistan. Likewise, there are very few smoking cessation programs designed to assist in quitting. Our study will allow for a better understanding of the culture-specific motivating factors and strategies that most contributed to successful quit attempts. Based on these results, evidence based smoking cessation interventions can be developed tailored to the socioeconomic demographic of our country and region, including smoking cessation clinics and public outreach and media campaigns highlighting key elements of successful smoking cessation.

Inside the adolescent voice: A qualitative analysis of the appeal of different tobacco products

INTRODUCTION

While cigarette use has decreased, adolescents’ overall use of tobacco (e.g. e-cigarettes, cigars, and hookah) has increased. The purpose of this qualitative study is to highlight the decision-making process of adolescents to use certain products over others and why certain tobacco products appeal to them.

METHODS

Twenty-five participants were recruited from a larger study surveying adolescents’ perceptions and tobacco use (772 high school students). The participants were involved in one-on-one semi-structured phone interviews on the appeal of different tobacco products. Interviews were recorded, transcribed verbatim, and analyzed by identifying relevant codes and themes.

RESULTS

Participants for this study had a mean age of 16.4 (SD=1.2) years; over half (14/25) were female. Three major themes emerged from the interviews: 1) social context and circumstances to use, including using and sharing with peers, and reducing boredom; 2) importance of flavors, smell, taste, smoke tricks, and accessibility of products; and 3) misperceptions and misinformation of product risks.

CONCLUSIONS

The findings that emerged showed why participants favored certain tobacco products, especially e-cigarettes, over others. The results support areas for future research and practice, and inform how interventions can better address the appeal of different tobacco products to ultimately prevent adolescent use.

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

BACKGROUND

Little is known about life-course factors that explain why some individuals continue smoking despite having smoking-related diseases.

PURPOSE

We examined (a) the extent to which early-life adversities are associated with the risk of recalcitrant smoking, (b) psychosocial factors that mediate the association, and (c) gender differences in the associations.

METHODS

Data were from 4,932 respondents (53% women) who participated in the first and follow-up waves of the Midlife Development in the U.S. National Survey. Early-life adversities include low socioeconomic status (SES), abuse, and family instability. Potential mediators include education, financial strain, purpose in life, mood disorder, family problems/support, and marital status. We used sequential logistic regression models to estimate the effect of early-life adversities on the risk of each of the three stages on the path to recalcitrant smoking (ever-smoking, smoking-related illness, and recalcitrant smoking).

RESULTS

For women, low SES (odds ratio [OR] = 1.29; 1.06-1.55) and family instability (OR = 1.73; 1.14-2.62) are associated with an elevated risk of recalcitrant smoking. Education significantly reduces the effect of childhood SES, yet the effect of family instability remains significant even after accounting for life-course mediators. For men, the effect of low SES on recalcitrant smoking is robust (OR = 1.48; 1.10-2.00) even after controlling for potential mediators. There are noteworthy life-course factors that independently affect recalcitrant smoking: for both genders, not living with a partner; for women, education; and for men, family problems.

CONCLUSIONS

The findings can help shape intervention programs that address the underlying factors of recalcitrant smoking.

Tobacco control policy and smoking among older Americans: An analysis of a nationally-representative longitudinal sample (1992-2014)

Smoking has decreased less rapidly among older adults than among the working age population in the United States. This study examines whether tobacco control policy, specifically smoke-free laws and increased cigarette prices, are associated with smoking cessation and lower smoking intensity among older adults. In addition, it considers whether the effect of smoke-free laws varied by labor force participation. Using geocoded longitudinal data from the Health and Retirement study collected from 1992 to 2014, I estimate survival models to evaluate the association between the implementation of city, county, and state smoke-free laws, changes in average state cigarette pack price, and smoking cessation among smokers. I then interact labor force status with smoke-free laws to assess whether the associations differ for retired versus employed respondents. Second, I estimate within-person fixed effects models to evaluate the association between the implementation of smoke-free laws, changes in average state cigarette pack price, and smoking intensity among smokers. Models were stratified by labor force status to assess whether the associations varied by labor force participation. All analyses were also stratified by age into younger (51-64) and older (65+) respondents. Neither the implementation of smoke-free laws nor increases in cigarette prices were associated with greater smoking cessation or lower smoking intensity. There was no evidence that labor force participation was associated with greater responsiveness to smoke-free laws. The results suggest that two of the most popular tobacco control policy tools in the US, smoke-free laws and cigarette prices, may be less effective among older adults.

Participation in a workplace smoking cessation program incentivized by lowering the cost of health care coverage: Findings from the LLUH BREATHE cohort

INTRODUCTION

Systematic analyses of workplace smoking cessation programs indicate that efficacy can be enhanced by using incentives. There is variation in the type of incentives used and their effect on participation and efficacy. The aim of our study was to examine whether lowering employee health plan costs (employee contributions, co-pays) encourage employee smokers to participate in workplace smoking cessation.

METHODS

We conducted a 2014-2015 prospective cohort study of 415 employee smokers of Loma Linda University Health (LLUH). The employees were offered participation in a workplace smoking cessation program (LLUH BREATHE Initiative) with the incentive of enrollment in an employer-provided health plan that had a 50% lower employee monthly contribution and co-payment relative to the employer-provided health plan for non-participants. Participation rates and variables associated with participation were analyzed.

RESULTS

In the LLUH BREATHE cohort, we found a very high rate of participation (72.7%; 95% CI: 69-77%) in workplace smoking cessation that was encouraged by a lower out-of-pocket health plan cost for the participating employee and/or spouse. Participation did, however, vary by gender and spouse, whereby female employee households with a qualifying smoker were more than two times more likely (employee: OR=2.89, 95% CI: 1.59-5.24; or spouse: OR=2.71, 95% CI: 1.47-5.00) to participate in smoking cessation than male employee households. The point prevalence, at four months, of abstinence from smoking among the participants was 48% (95% CI: 42-54%).

CONCLUSIONS

Our findings indicate that a workplace smoking cessation program that uses a novel reward-based incentive of lower out-of-pocket health plan costs results in a participation rate that is much higher than US norms.

Sex Differences in Use of Smoking Cessation Services and Resources: A Real-World Study

Objectives:

Smoking cessation interventions with sex considerations have been found to effectively increase cessation rates. However, evidence is limited and weak. This study examined sex differences in the use of smoking cessation services or resources among Ontario adults.

Methods:

Data are from the Smokers’ Panel, an ongoing online survey of Ontario adult smokers and recent quitters. The analysis included 1009 male and 1765 female participants. Bivariate analysis was used to examine differences in sociodemographic characteristics and smoking-related variables by use of cessation services/resources. Logistic regression was then used to identify sociodemographic characteristics and smoking-related variables associated with the use of cessation services/resources.

Results:

The analysis shows that there were significant sex differences in the use of individual interventions. Female participants were more likely to use nicotine patch (63% vs 58%; adjusted odds ratio, AOR: 1.39, 95% confidence interval [CI]: 1.16-1.67), varenicline (29% vs 24%; AOR: 1.37, 95% CI: 1.13-1.66), Smokers’ Helpline phone (14% vs 10%; AOR: 1.39, 95% CI: 1.07-1.79), Smokers’ Helpline online (27% vs 21%; AOR 1.43, 95% CI: 1.18-1.74), self-help materials (23% vs 16%; AOR: 1.81 95% CI: 1.46-2.26), and alternative methods (23% vs 19%; AOR: 1.40, 95% CI: 1.14-1.73) compared with male participants, after adjusting for covariates.

Conclusion:

Consistent with other findings, the study shows sex differences in the use of smoking cessation services or resources among adult smokers. Women are more likely to use recommended cessation resources such as nicotine patch, varenicline, and Smokers’ Helpline than men. Health professionals should use this increased willingness to help female smokers quit. However, men may be underserved and more men-specific interventions need to be developed and evaluated.

A planning intervention to quit smoking in single-smoking couples: does partner involvement improve effectiveness?

OBJECTIVE

Smoking cessation interventions that use implementation intentions have shown promising results. Implementation intentions are if-then plans that specify certain behaviour within a situational context. This study examines whether dyadic planning (i.e., involving a non-smoking partner) is more effective than individual planning in quitting smoking.

DESIGN

This longitudinal single-blind randomized controlled trial involves a baseline questionnaire, end-of-day measurements for three weeks, and a follow-up questionnaire after three months. Single-smoking couples were randomized to a dyadic or individual planning condition. After the intervention, which 176 couples received, smokers attempted to quit smoking, and the diary measurements started.

MAIN OUTCOME MEASURES

smoking abstinence, number of cigarettes smoked and relationship satisfaction.

RESULTS

At follow-up, both planning groups showed similar quit rates (33%, dyadic; 30%, individual) and a similar significant decline in number of cigarettes smoked (almost 50%). For most smokers, the smoking pattern shown in the diary seemed to be indicative of smoking behaviour at follow-up. Relationship satisfaction declined minimally, in both intervention groups and in both smokers and partners.

CONCLUSION

The involvement of a non-smoking partner in the planning did not increase its effectiveness. However, couple participation and daily measurements during a quit attempt could be important components of future interventions.

Informal and Formal Social Integration Shape Eating and Drinking of Older Black and White Americans

Objective: Health behaviors are seen as one possible pathway linking race to health outcomes. Social integration has also been consistently linked to important health outcomes but has not been examined as a mechanism accounting for racial differences in health behaviors among older U.S. adults. Method: We use data from the American's Changing Lives (ACL) Study to explore racial differences in measures of social integration and whether they help account for racial differences in several dietary behaviors and alcohol use. Results: We find differences by race and social integration measures in dietary behaviors and alcohol use. Net of socioeconomic status, health status, and reported discrimination, variation in social integration helps to account for racial differences in some health behaviors. Discussion: Our results highlight the nuanced role of social integration in understanding group differences in health behaviors. Interventions should consider such complexities when including aspects of social integration in their design.

Social influences on smoking cessation in mid-life: Prospective cohort of UK women

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.

Influence of Social Connections on Smoking Behavior across the Life Course

Although we know much about demographic patterns of smoking, we know less about people's explanations for when, how and why they avoid, develop, or alter smoking habits and how these explanations are linked to social connections across the life course. We analyze data from in-depth interviews with 60 adults aged 25-89 from a large southwestern U.S. city to consider how social connections shape smoking behavior across the life course. Respondents provided explanations for how and why they avoided, initiated, continued, and/or quit smoking. At various times, social connections were viewed as having both positive and negative influences on smoking behavior. Both people who never smoked and continuous smokers pointed to the importance of early life social connections in shaping decisions to smoke or not smoke, and viewed later connections (e.g., marriage, coworkers) as less important. People who quit smoking or relapsed tended to attribute their smoking behavior to social connections in adulthood rather than early life. People who changed their smoking behavior highlighted the importance of transitions as related to social connections, with more instability in social connections often discussed by relapsed smokers as a reason for instability in smoking status. A qualitative approach together with a life course perspective highlights the pivotal role of social connections in shaping trajectories of smoking behavior throughout the life course.

The Association of Peer Smoking Behavior and Social Support with Quit Success in Employees Who Participated in a Smoking Cessation Intervention at the Workplace

The current study investigated whether quit success among employees who participated in a smoking cessation intervention at the workplace was associated with social support from, and the smoking behavior of, people in their environment. Tobacco-smoking employees (n = 604) from 61 companies participated in a workplace group smoking cessation program. Participants completed questionnaires assessing social support from, and the smoking behavior of, people in their social environment. They were also tested for biochemically validated continuous abstinence directly after finishing the training and after 12 months. The data were analyzed using mixed-effects logistic regression analyses. Social support from colleagues was positively associated with 12-month quit success (odds ratio (OR) = 1.85, 95% confidence interval (CI) = 1.14-3.00, p = 0.013). Support from a partner was positively associated with short-term quit success (OR = 2.01, 95% CI = 1.23-3.30, p = 0.006). Having a higher proportion of smokers in the social environment was negatively associated with long-term abstinence (OR = 0.81, 95% CI = 0.71-0.92, p = 0.002). Compared to having a non-smoking partner, long-term quit success was negatively associated with having no partner (OR = 0.48, 95% CI = 0.26-0.88, p < 0.019), with having a partner who smokes (OR = 0.40, 95% CI = 0.24-0.66, p < 0.001), and with having a partner who used to smoke (OR = 0.47, 95% CI = 0.26-0.86, p = 0.014). In conclusion, people in a smoker's social environment, particularly colleagues, were strongly associated with quit success. The workplace may, therefore, be a favorable setting for smoking cessation interventions.

A dyadic planning intervention to quit smoking in single-smoking couples: design of a randomized controlled trial

Background

Tobacco use is the largest preventable cause of death. Smoking cessation interventions that use implementation intentions show promising results. Implementation intentions are if-then plans that specify a certain behaviour within a situational context. This study will examine whether involving a non-smoking partner could improve planning interventions, and whether and which partner interactions underlie this effectiveness.

Methods

This single-blind randomized controlled trial has a longitudinal design with a baseline questionnaire, end-of-day measurements for three weeks starting on the quit date, and a follow-up questionnaire after three months.

Participants: single-smoking couples who live together and are in a relationship for more than one year.

Setting: couples are randomized to either a dyadic or individual planning condition. After the intervention the smoker attempts to quit smoking and the diary measurements start.

Measurements: The primary outcome variable is smoking abstinence. Secondary outcome measures are smoking behaviour and relationship satisfaction. Partner interactions are examined as a possible mediator.

Discussion

This RCT is the first to examine the effectiveness of dyadic planning to quit smoking in single-smoking couples. Partner interactions are thought to play an important role during the quit attempt, and therefore in the effectiveness of the intervention. This RCT will provide more insight into which daily partner interactions are beneficial for smoking abstinence and the couples’ relationship satisfaction, and whether the type of intervention is related to different types or levels of partner interactions and smoking behaviour. When proven effective, this planning intervention in combination with coaching for the non-smoking partner will be a valuable and low-cost addition to existing smoking interventions.

Trial registration

The trial is retrospectively registered on 19/04/2017 on www.trialregister.nl (TC: 6398).

Electronic supplementary material

The online version of this article (10.1186/s40359-018-0266-8) contains supplementary material, which is available to authorized users.

Concordance in the Health Behaviors of Couples by Age: A Cross-sectional Study

Objectives

To investigate concordance in the health behaviors of women and their partners according to age and to investigate whether there was a stronger correlation between the health behaviors of housewives and those of their partners than between the health behaviors of non-housewives and those of their partners.

Methods

We used data obtained from women participants in the 2015 Korea Community Health Survey who were living with their partners. The outcome variables were 4 health behaviors: smoking, drinking, eating salty food, and physical activity. The main independent variables were the partners’ corresponding health behaviors. We categorized age into 4 groups (19-29, 30-49, 50-64, and ≥ 65 years) and utilized multivariate logistic regression analysis, stratifying by age group. Another logistic regression analysis was stratified by whether the participant identified as a housewife.

Results

Data from 64 971 women older than 18 years of age were analyzed. Of the 4 health behaviors, the risk of smoking (adjusted odds ratio [aOR], 4.65; 95% confidence interval [CI], 3.93 to 5.49) was highest when the participant’s partner was also a smoker. Similar results were found for an inactive lifestyle (aOR, 2.56; 95% CI, 2.45 to 2.66), eating salty food (aOR, 2.48; 95% CI, 2.36 to 2.62); and excessive drinking (aOR, 1.89; 95% CI, 1.80 to 1.98). In comparison to non-housewives, housewives had higher odds of eating salty food.

Conclusions

The health behaviors of women were positively correlated with those of their partners. The magnitude of the concordance differed by age group.