Health Events and the Smoking Cessation of Middle Aged Americans

Falba, Tracy

doi:10.1007/s10865-005-2560-1

Cited by 40 publications

(48 citation statements)

References 32 publications

(31 reference statements)

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“…Male smokers with shorter TL may have been more likely to quit because short TL was correlated with poorer health among men in the HRS; furthermore, previous studies from the HRS showed that smokers who experience acute and chronic health events are more likely to quit smoking than are individuals who do not (37,38). This may be an example of the "healthy smoker" phenomenon, in which individuals who are more resistant to the adverse effects of smoking continue to smoke, whereas those who are more susceptible quit, resulting in underestimation of the effect of smoking (39).…”

Section: Discussionmentioning

confidence: 99%

“…This may be an example of the "healthy smoker" phenomenon, in which individuals who are more resistant to the adverse effects of smoking continue to smoke, whereas those who are more susceptible quit, resulting in underestimation of the effect of smoking (39). This adverse health-driven smoking cessation may be particularly relevant to men in the HRS, because they are more likely to experience major and chronic health events (37), and to older individuals, who are more likely than younger individuals to experience adverse health events and to quit smoking in response (40). Recent smoking cessation after entering study as a smoker a The percentage of missing data among subjects with telomere length measurement was <1% (31 of 5,554) for wave 9 smoking status, 1% (8 of 724) for wave 9 smoking rate, 15% (366 of 2,414) for years since smoking cessation, 18% (565 of 3,138) for smoking duration, and 2% (28 of 1,243) for "on-study" pack-years.…”

Section: Discussionmentioning

confidence: 99%

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Sex-Specific and Time-Varying Associations Between Cigarette Smoking and Telomere Length Among Older Adults

Zhang¹,

Lauderdale²,

Pierce³

2016

Am. J. Epidemiol.

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Inconsistent associations between smoking and telomere length (TL) have been reported in epidemiologic studies, perhaps because of the time-varying nature of smoking behaviors. We estimated the associations of TL, which was measured by quantitative polymerase chain reaction using saliva DNA, with concurrent and past smoking status reported biennially for up to 16 years before TL measurement in 5,624 participants in the Health and Retirement Study (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008). Smoking was associated with reduced TL when we used prospective data on smoking statuses among men and women, but the association was strongly attenuated among men in crosssectional analyses. This attenuation was largely due to a higher rate of smoking cessation during the study period among men with shorter TL than among men with longer TL. Short TL was also associated with poorer overall health in men, which suggests that male smokers with short TL were more likely to quit smoking because of poor health. Analyses of years since cessation, smoking duration, and pack-years of smoking all support the hypothesis that increased cigarette use shortens TL. Our results provide a potential explanation for the inconsistent associations between smoking and TL reported in previous cross-sectional studies. Time-varying associations should be considered in future studies of smoking behavior, TL, aging, and disease risk.aging; Health and Retirement Study; sex; smoking; smoking cessation; telomere length Abbreviations: HRS, Health and Retirement Study; TL, telomere length.Telomeres are DNA-protein complexes at chromosome ends that protect DNA from damage. Shortening of the DNA component of telomeres occurs with cell division, with average leukocyte telomere length (TL) decreasing by approximately 25 to 50 base pairs per year in adults (1). TL has been studied extensively as a biomarker of aging and susceptibility to age-related diseases, including cardiovascular diseases, cancers, and neurocognitive diseases (2-5).Cigarette smoking results in exposure to free radicals and reactive oxygen species, which leads to increased oxidative stress and inflammation (6). Both processes have also been linked to TL shortening (7-9), leading to the hypothesis that smoking promotes TL shortening (10). However, epidemiologic reports of smoking and TL have been inconsistent; in some studies, investigators reported shorter TL associated with smoking (11-20), whereas others found no association (21)(22)(23)(24)(25)(26). This inconsistency has also been seen in studies of smoking and longitudinal measures of TL attrition, with associations between smoking and TL shortening seen in some studies (17, 18) but not in others (19,20). Furthermore, a study of older men in Finland (27) found that smoking during midlife was associated with short TL measured later in life but that smoking was not associated with TL in crosssectional analyses conducted in later life, which suggests that the timing of smoking beh...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sex-Specific and Time-Varying Associations Between Cigarette Smoking and Telomere Length Among Older Adults

Zhang¹,

Lauderdale²,

Pierce³

2016

Am. J. Epidemiol.

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“…Self-reports of new disease diagnoses by physicians are also included in the model. Several of these have been found to increase use of clinical services (Wu 2003) and to encourage healthier behavior, such as quitting smoking (Falba 2005). Diagnoses by physicians also have the advantage of being somewhat more objective measures of health status.…”

Section: Methodsmentioning

confidence: 99%

Spousal Concordance in Health Behavior Change

Falba

Sindelar

2007

Health Services Research

225

177

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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

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“…While the FE models are able to address biases due to time-invariant unobserved factors, they do not account for time-varying unobserved variables affecting both smoking and cognition. Particularly in the case of older individuals, events such as health shocks or decreased labor force participation are common and such events have been shown to affect both smoking and cognition (Falba, 2005;Khwaja et al, 2006;Keenan, 2009;Savva and Stephan, 2010). To account for such time varying factors, we re-estimate the FE models adding extensive controls for health, income and retirement status (see Table 6).…”

Section: Resultsmentioning

confidence: 99%