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Article
Racial and Ethnic Differences in Smoking Changes after Chronic Disease Diagnosis Among Middle-Aged and Older Adults in the United States
BMC Geriatrics
  • Ana R. Quinones, OHSU-PSU School of Public Health, Oregon Health & Science University
  • Corey L. Nagel, Oregon Health & Science University
  • Jason T. Newsom, Portland State University
  • Nathalie Huguet, Portland State University
  • Paige Sheridan, OHSU-PSU School of Public Health, Oregon Health & Science University
  • Stephen M. Thielke, Geriatric Research, Education, and Clinical Center, Puget Sound VA Medical Center
Document Type
Article
Publication Date
1-1-2017
Subjects
  • Smoking-- psychology -- United States,
  • Smoking -- Research -- United States
Disciplines
Abstract

Background

Middle-aged and older Americans from underrepresented racial and ethnic backgrounds are at risk for greater chronic disease morbidity than their white counterparts. Cigarette smoking increases the severity of chronic illness, worsens physical functioning, and impairs the successful management of symptoms. As a result, it is important to understand whether smoking behaviors change after the onset of a chronic condition. We assessed the racial/ethnic differences in smoking behavior change after onset of chronic diseases among middle-aged and older adults in the US. Methods

We use longitudinal data from the Health and Retirement Study (HRS 1992–2010) to examine changes in smoking status and quantity of cigarettes smoked after a new heart disease, diabetes, cancer, stroke, or lung disease diagnosis among smokers. Results

The percentage of middle-aged and older smokers who quit after a new diagnosis varied by racial/ethnic group and disease: for white smokers, the percentage ranged from 14% after diabetes diagnosis to 32% after cancer diagnosis; for black smokers, the percentage ranged from 15% after lung disease diagnosis to 40% after heart disease diagnosis; the percentage of Latino smokers who quit was only statistically significant after stoke, where 38% quit. In logistic models, black (OR = 0.43, 95% CI: 0.19–0.99) and Latino (OR = 0.26, 95% CI: 0.11–0.65) older adults were less likely to continue smoking relative to white older adults after a stroke, and Latinos were more likely to continue smoking relative to black older adults after heart disease onset (OR = 2.69, 95% CI [1.05–6.95]). In models evaluating changes in the number of cigarettes smoked after a new diagnosis, black older adults smoked significantly fewer cigarettes than whites after a new diagnosis of diabetes, heart disease, stroke or cancer, and Latino older adults smoked significantly fewer cigarettes compared to white older adults after newly diagnosed diabetes and heart disease. Relative to black older adults, Latinos smoked significantly fewer cigarettes after newly diagnosed diabetes. Conclusions

A large majority of middle-aged and older smokers continued to smoke after diagnosis with a major chronic disease. Black participants demonstrated the largest reductions in smoking behavior. These findings have important implications for tailoring secondary prevention efforts for older adults.

Description

© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Version of record can be found at https://doi.org/10.1186/s12877-017-0438-z

DOI
10.1186/s12877-017-0438-z
Persistent Identifier
http://archives.pdx.edu/ds/psu/19840
Citation Information
Quiñones, A. R., Nagel, C. L., Newsom, J. T., Huguet, N., Sheridan, P., & Thielke, S. M. (2017). Racial and ethnic differences in smoking changes after chronic disease diagnosis among middle-aged and older adults in the United States. BMC geriatrics, 17(1), 48.