Objective. This study examines the degree to which a married individual's health habits and use of preventive medical care are influenced by his or her spouse's behaviors. Study Design. Using longitudinal data on individuals and their spouses, we examine changes over time in the health habits of each person as a function of changes in his or her spouse's health habits. Specifically, we analyze changes in smoking, drinking, exercising, cholesterol screening, and obtaining a flu shot. Data Source. This study uses data from the Health and Retirement Study (HRS), a nationally representative sample of individuals born between 1931 and 1941 and their spouses. Beginning in 1992, 12,652 persons (age-eligible individuals as well as their spouses) from 7,702 households were surveyed about many aspects of their life, including health behaviors, use of preventive services, and disease diagnosis. Sample. The analytic sample includes 6,072 individuals who are married at the time of the initial HRS survey and who remain married and in the sample at the time of the 1996 and 2000 waves. Principal Findings. We consistently find that when one spouse improves his or her behavior, the other spouse is likely to do so as well. This is found across all the behaviors analyzed, and persists despite controlling for many other factors. Conclusions. Simultaneous changes occur in a number of health behaviors. This conclusion has prescriptive implications for developing interventions, treatments, and policies to improve health habits and for evaluating the impact of such measures.Key Words. Spouse, smoking, alcohol, exercise, preventive services Smoking, drinking, and obesity have all garnered much attention for their detrimental effects on health and other outcomes. Behaviors such as exercise and a healthy diet, in contrast, can have positive effects on health. Similarly, the use of preventive services, such as cholesterol screening and flu shots, can lead to additional years of life. A critical question is how to improve the health of the public by encouraging healthy decisions. This paper focuses on the role of the spouse in shaping individual's health habits and decisions to use r Health Research and Educational Trust

Overall, stressful life events appear to have a greater deleterious effect on continued abstinence and the ability to quit smoking for women when compared to men. In particular, health and financial events are important risk factors for women and tobacco use.

Background: Screening for alcohol use in primary care settings is recommended by clinical care guidelines but is not adhered to as strongly as screening for smoking. It has been proposed that smoking status could be used to enhance the identification of alcohol misuse in primary care and other medical settings, but national data are lacking. Our objective was to investigate smoking status as a clinical indicator for alcohol misuse in a national sample of US adults, following clinical care guidelines for the assessment of these behaviors. Methods: Analyses are based on a sample of 42 374 US adults from the National Epidemiological Survey on Alcohol and Related Conditions (Wave I, 2001-2002). Odds ratios (ORs), 95% confidence intervals (CIs), and test characteristics (sensitivity, specificity, positive and negative predictive values, and positive likelihood ratio of smoking behavior [daily, occasional, or former]) were determined for the detection of hazardous drinking behavior and alcohol-related diagnoses, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV. Results: Daily, occasional, and ex-smokers were more likely than never smokers to be hazardous drinkers (OR, 3.23 [95% CI, 3.02-3.46]; OR, 5.33 [95% CI, 4.70-6.04]; OR, 1.19 [95% CI, 1.10-1.28], respectively). Daily and occasional smokers were more likely to meet criteria for alcohol diagnoses (OR, 3.52 [95% CI, 3.19-3.90] and OR, 5.39 [95% CI, 4.60-6.31], respectively). For the detection of hazardous drinking by current smoking (occasional smokersϩdaily smokers), sensitivity was 42.5%; specificity, 81.9%; positive predictive value, 45.3% (vs population rate of 26.1%); and positive likelihood ratio, 2.34. For the detection of alcohol diagnoses by current smoking, sensitivity was 51.4%; specificity, 78.0%; positive predictive value, 17.8% (vs population rate of 8.5%); and positive likelihood ratio, 2.33. Conclusions: Occasional and daily smokers were at heightened risk for hazardous drinking and alcohol use diagnoses. Smoking status can be used as a clinical indicator for alcohol misuse and as a reminder for alcohol screening in general.

Aims To assess the impact of involuntary job loss due to plant closure or layoff on relapse to smoking and smoking intensity among older workers.Design, participants, sample Data come from the Health and Retirement Study, a nationally representative survey of older Americans aged 51-61 in 1991 followed every 2 years beginning in 1992. The 3052 participants who were working at the initial wave and had any history of smoking comprise the main sample.Methods Primary outcomes are smoking relapse at wave 2 (1994) among baseline former smokers, and smoking quantity at wave 2 among baseline current smokers. As reported at the wave 2 followup, 6.8% of the sample experienced an involuntary job loss between waves 1 and 2. Findings Older workers have over two times greater odds of relapse subsequent to involuntary job loss than those who did not. Further, those who were current smokers prior to displacement that did not obtain new employment were found to be smoking more cigarettes, on average, post-job loss.

Results suggest that the true costs of late career unemployment exceed financial deprivation, and include substantial health consequences. Physicians who treat individuals who lose jobs as they near retirement should consider the loss of employment a potential risk factor for adverse vascular health changes. Policy makers and programme planners should also be aware of the risks of job loss, so that programmatic interventions can be designed and implemented to ease the multiple burdens of joblessness.