Association Between Social Isolation and Smoking in Japan and England.

Takaaki Ikeda,Shihoko Koyama,Masashige Saito,Katsunori Kondo,Ken Osaka,Noriko Cable,Jun Aida,Taishi Tsuji,Taiji Noguchi

doi:10.2188/jea.je20200138

Abstract

BackgroundExisting evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status.MethodsWe performed a repeated cross-sectional study using two waves of data from two ongoing aging studies: the English Longitudinal Study of Ageing and the Japan Gerontological Evaluation Study. Participants from both studies aged ≥65 years were included. We applied a multilevel Poisson regression model to examine the association between social isolation and smoking status and adjusted for individual sociodemographic characteristics. We used the social isolation index which comprises the following domains: marital status; frequency of contact with friends, family, and children; and participation in social activities. Interaction terms between each country and social isolation were also entered into the mode.ResultsAfter exclusion of never smokers, we analyzed 75,905 participants (7,092 for ELSA and 68,813 for JAGES, respectively). Taking ex-smokers as the reference, social isolation was significantly associated with current smoking; the prevalence ratios (PRs) were 1.06 (95% credible interval [CrI], 1.05–1.08) for men and 1.08 (95% CrI, 1.04–1.11) for women. Taking Japan as a reference, the interaction term between country and social isolation was significant for both sexes, with increased PRs of 1.32 (95% CrI, 1.14–1.50) for men and 1.30 (95% CrI, 1.11–1.49) for women in England.ConclusionsOlder people who were less socially isolated were more likely to quit smoking in England than in Japan, possibly explained by the strict tobacco control policies in England.

Highlights

Smoking continues to be one of the leading global causes of cardiovascular-related diseases and mortality.[1,2] The prevalence of smoking is high worldwide, especially among men, and in 2015, 35% of men and 6% of women were reported as smokers.[2]
The proportion of current smokers was higher in men but lower in women in Japan Gerontological Evaluation Study (JAGES) than in English Longitudinal Study of Ageing (ELSA)
In both men and women, more people with social isolation smoked than those who did not, and this was higher in ELSA than in JAGES participants

Summary

Introduction

Smoking continues to be one of the leading global causes of cardiovascular-related diseases and mortality.[1,2] The prevalence of smoking is high worldwide, especially among men, and in 2015, 35% of men and 6% of women were reported as smokers.[2]. A cross-sectional study from South Korea showed that more extensive social networks, such as having a partner, friends, relatives, and social activities, were negatively associated with current smoking status among older women.[4] In a cohort study conducted in the United States,[5] social network effects of smoking cessation were supported by a significant and positive association between smoking cessation by family members, relatives, and friends and smoking cessation of the study participants. Social isolation, defined as a state in which objectively quantifiable social interactions, contacts, and networks are absent,[6,7,8] was associated with smoking, meaning that socially isolated individuals are likely to be smokers.[6]. Existing evidence suggest that those who are socially isolated are at risk for taking up or continuing smoking. This study investigated country-based differences in social isolation and smoking status

Methods

Results

Conclusion