Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects

The association between parenthood and health: A comparison of people in same-sex and different-sex relationships

Understanding social inequalities in parental health is crucial for family functioning and child development. Theoretically, the double burden of parenting and minority stress may lead to the negative association between parenthood and health outcomes being stronger for people in same-sex relationships. Moreover, drawn from the social control process and the compensation mechanism, the negative association between parenthood and health risk behaviors may become stronger for people in same-sex relationships. Yet, empirical evidence on parental health disparities between parents in same- and different-sex relationships is limited. Using linear and logistic regression models, coarsened exact matching, and entropy balancing on Dutch data between 2008 and 2021 (196 people in same-sex relationships and 6948 people in different-sex relationships), we investigate the relationship between parenthood and three health outcomes (self-rated health, physical health, and mental health) and two health risk behaviors (smoking and heavy episodic drinking). We find that parents on average are less likely to experience heavy episodic drinking than non-parents. The association between parenthood and health does not differ between people in same-sex and different-sex relationships.

Understanding adaptability in the family environment in facing COVID-19: A review

Adaptation is a research field that is trending in the face of the coronavirus disease 2019 (COVID-19) outbreak in various parts of the country. The ability to adapt is one way for individuals to survive in uncertain situations. This article reviews the adaptation process in a family environment focusing on finding models from various literatures on family institution adaptations and then mapping them into adaptations that families can implement during the COVID-19 pandemic. Our study showed that family resilience in dealing with changes in various areas of life was performed through family adaptations during the COVID-19 pandemic, such as: (a) the ability of family members to be more open and respect privacy when communicating during all activities at home, (b) culture and values applied in the family are the determining factors for individuals to be able to adapt to new habits, (c) the resources owned by the family determine the attitudes and ways in which the family develops its potential in dealing with limitations and negative emotions, (d) the adaptive power of men as husbands or fathers with women as wives or mothers is driven by different factors, where men are driven generally due to external factors, while women due to internal factors. Families with different environments produce different adaptability, depending on the social capital and support received by the family.

Association between Parenthood and Health Behaviour in Later Life-Results from the Population-Based CARLA Study

Previous research has focused on comparing health behaviour between parents and non-parents at younger ages, while little is known about the impact of being a parent on health behaviours in later life. We studied whether parenthood is associated with later physical activity (PA), dietary pattern, smoking status and alcohol consumption in German adults of middle and old age. We used data from the baseline examination of the population-based CARLA-study in Halle (Saale), comprising 1779 adults aged 45-83. Linear and logistic regression analyses assessed the relationship between parenthood and health behaviours while controlling for age, partner status, education, income, occupational position, socioeconomic status in childhood, and number of chronic diseases. Of the participants, 89.1% had biological children. Being a father was associated with higher PA in sports (sport index ß = 0.29, 95% confidence interval [0.14; 0.44]), but not with PA in leisure time (excluding sports), dietary pattern, consumption of alcohol and smoking status. No associations were found between being a mother with all outcome variables. Provided that PA of fathers is typically reduced when the children are young, the development towards higher PA at later age needs to be studied in more detail.

Has the distribution of smoking across young adult transition milestones changed over the past 20 years? Evidence from the 1970 British Cohort Study (1996) and Next Steps (2015-16)

Introduction

Transitions into work and family life during young adulthood exacerbate differences in the progression of smoking over the life-course. Few have considered how changes in smoking and the transition to adulthood in the past two decades have influenced these relationships over time.

Methods

We compared the distribution of smoking at ages 25–26 across transition milestones among 3764 men and 4568 women in the 1970 British Cohort study (1996) and 3426 men and 4281 women in the Next Steps study (2015–16). We regressed occasional and daily smoking status on educational attainment, economic activity, living arrangements, relationship status, and parenthood, adjusting for family background, socio-demographics, and smoking history.

Results

There were few differences in associations between the 1996 and 2015-16 samples. Young men and women were less likely to smoke if they had higher education, were homeowners, and cohabited with a partner. Women were less likely to smoke occasionally if they were full-time students, and men were less likely to smoke daily if they were employed full-time and not living with children. However, comparing associations in 2015–16 to 1996: 1) in men, higher education had a weaker negative association and living with a partner had a stronger negative association with daily smoking; 2) in women, independently renting had a weaker positive association with daily smoking.

Conclusions

Despite considerable changes in smoking and the transition to adulthood over the past two decades, the distribution of smoking at ages 25–26 across transition milestones has been relatively stable during this time period in Great Britain.

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Smoking at ages 25–26 was associated with economic activity, living arrangements, relationship status, and parenthood in 1996 and 2015–16.

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Differences in smoking across transition milestones differed by gender.

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Differences in smoking did not substantially change between 1996 and 2015–16.

The association between parity, CVD mortality and CVD risk factors among Norwegian women and men

BACKGROUND

Several studies have shown that women and men with two children have lower mortality than the childless, but there is less certainty about mortality, including CVD mortality, at higher parities and meagre knowledge about factors underlying the parity-mortality relationship.

METHODS

The association between parity and CVD mortality was analyzed by estimating discrete-time hazard models for women and men aged 40-80 in 1975-2015. Register data covering the entire Norwegian population were used, and the models included a larger number of relevant sociodemographic control variables than in many previous studies. To analyze the relationship between parity and seven CVD risk factors, logistic models including the same variables as the mortality models were estimated from the CONOR collection of health surveys, linked to the register data.

RESULTS

Men (but not women) who had four or more children had higher mortality from CVD than those with two, although this excess mortality was not observed for the heart disease sub-group. Overweight, possibly in part a result of less physical activity, seems to play a role in this. All CVD risk factors except smoking and alcohol may contribute to the relatively high CVD mortality among childless.

CONCLUSIONS

Childbearing is related to a number of well-known CVD risk factors, and becoming a parent or having an additional child is, on the whole, associated with lower-or at least not higher-CVD mortality in Norway. However, for men family sizes beyond three children are associated with increased CVD mortality, with risks of overweight one possible pathway.

Association of Childbearing With a Short-Term Reduced Risk of Crohn Disease in Mothers

Our aim in this study was to analyze the importance of childbearing for risk of inflammatory bowel disease. Using data from the Norwegian Population Register and the Norwegian Patient Register, we fitted discrete-time hazard models for diagnosis of Crohn disease (CD) or ulcerative colitis (UC) among men and women aged 18-81 years in 2011-2016. Year and various sociodemographic factors were controlled for. The data included 4,304 CD cases and 8,866 UC cases. Women whose youngest child was ≤4 years of age had lower CD risk the following year than childless women (odds ratio (OR) = 0.73, 95% confidence interval (CI): 0.62, 0.86). There was no such reduction in CD risk among fathers. Men whose youngest child was aged ≥20 years had higher risks of CD (OR = 1.22, 95% CI: 1.01, 1.49) and UC (OR = 1.15, 95% CI: 1.02, 1.30) than childless men. UC risk was also increased among men whose youngest child was aged ≤4 years (OR = 1.14, 95% CI: 1.02, 1.27). The short-term reduction in women's CD risk after a birth may reflect biological effects of pregnancy. Alternatively, it may reflect residual confounding or lifestyle effects of parenthood that are of special relevance for CD in women. In particular, differences in use of oral contraceptives (which it was not possible to control for) may have contributed to the observed pattern.

Explaining the social gradient in smoking and cessation: the peril and promise of social mobility

Smoking in high-income countries is now concentrated in poor communities whose relatively high smoking prevalence is explained by greater uptake but above all by lower quit rates. Whilst a number of barriers to smoking cessation have been identified, this is the first paper to situate cessation itself as a classed and cultural practice. Drawing on ethnographic research carried out in a working-class community in the North of England between 2012 and 2015, I theorise smoking cessation as a symbolic practice in relation to the affective experience of class and social mobility. I show that ambivalence about upward mobility as separation and loss translated into ambivalence about smoking cessation. The reason for this was that the social gradient in smoking operated dynamically at the level of the individual life course, i.e. smoking cessation followed upward mobility. A serious health problem was an appropriate reason to quit but older women continued to smoke despite serious health problems. This was linked to historical gender roles leading to women placing a low priority on their own health as well as the intergenerational reproduction of smoking through close affective links with smoking parents.

Dynamic, data-driven typologies of long-term smoking, cessation, and their correlates: Findings from the International Tobacco Control (ITC) Netherlands Survey

RATIONALE

Efforts towards tobacco control are numerous, but relapse rates for smoking cessations remain high. Behavioral changes necessary for continuous cessation appear complex, variable and subject to social, biological, psychological and environmental determinants. Currently, most cessation studies concentrate on short-to midterm behavioral changes. Besides, they use fixed typologies, thereby failing to capture the temporal changes in smoking/cessation behaviors, and its determinants.

OBJECTIVE

To obtain long-term, data-driven longitudinal patterns or profiles of smoking, cessation, and related determinants in a cohort of adult smokers, and to investigate their dynamic links.

METHODS

The dataset originated from the International Tobacco Control (ITC) Netherlands Project, waves 2008 to 2016. Temporal dynamics of smoking/cessation, psychosocial constructs, and time-varying determinants of smoking were extracted with Group-Based Trajectory Modeling technique. Their associations were investigated via multiple regression models.

RESULTS

Substantial heterogeneity of smoking and cessation behaviors was unveiled. Most respondents were classified as persistent smokers, albeit with distinct levels of consumption. For a minority, cessation could be sustained between 1 and 8 years, while others showed relapsing or fluctuating smoking behavior. Links between smoking/cessation trajectories with those of psychosocial and sociodemographic variables were diverse. Notably, changes in two variables were aligned to behavioral changes towards cessation: decreasing number of smoking peers and attaining a higher self-perceived control.

CONCLUSION

The unveiled heterogeneity of smoking behavior over time and the varied cross-dependencies between smoking data-driven typologies and those of underlying risk factors underscore the need of individually tailored approaches for motivational quitting.

Considering the age-graded nature of associations between socioeconomic characteristics and smoking during the transition towards adulthood

Young adulthood is a sensitive period characterized by the accumulation of resources and transitions in and out of education, employment, family, and housing arrangements. The association between these characteristics and smoking outcomes likely varies with age yet few studies address its dynamic age-graded nature. To explore this, we examined 2083 young adults ages 18-25 from the 2011-2012 cross-sectional sample of the Montreal-based Interdisciplinary Study of Inequalities in Smoking. We operationalized participants' socioeconomic characteristics using their resources (e.g., education, income, financial difficulties) and transition stages (i.e., studying, working full-time, living arrangements with parents and children, and being in a relationship). We examined differences in these characteristics' associations with occasional and daily smoking across two-year categories (18-19, 20-21, 22-23, and 24-25) using multinomial logistic regression models with age-based interaction terms. Findings highlighted four characteristics, i.e., educational attainment, personal income, student status, and relationship status, with significant differences in associations with smoking outcomes across age categories. Between the age groups of 18-19 and 24-25: 1) the negative association between low educational attainment and daily smoking increased; 2) the positive association between personal income and daily smoking decreased; 3) the negative association between student status and both outcomes decreased; 4) the negative association between relationship status and occasional smoking increased. Findings support that the associations between young adults' socioeconomic characteristics and smoking outcomes vary substantially during the second and third decades of life. Addressing this has critical implications for identifying vulnerable populations and developing appropriate age-based policies in this age group.