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社会资本与吸烟行为随时间的变化:基于人群的时间关系面板研究

Changes in Social Capital and Cigarette Smoking Behavior Over Time: A Population-Based Panel Study of Temporal Relationships.

作者信息

Lindström Martin, Giordano Giuseppe N

机构信息

Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Faculty of Medicine, Lund University, Lund, Sweden.

Centre for Economic Demography (CED), Lund University, Lund, Sweden.

出版信息

Nicotine Tob Res. 2016 Nov;18(11):2106-2114. doi: 10.1093/ntr/ntw120. Epub 2016 Apr 25.

Abstract

INTRODUCTION

Identifying factors that influence individuals' smoking behavior remains a huge public health concern. This study aimed to investigate changes in individuals' cigarette smoking while considering well-known smoking determinants, including social capital, its presence being postulated to reduce smoking.

METHODS

From British Household Panel Survey data, two baseline smoking cohorts were created ("smoking" and "not smoking"). The same individuals from this nationally representative sample (N = 8114, aged 16-91 years) were interviewed on four occasions between years 2000 and 2007 to investigate changes in cigarette smoking behavior. Logistic regression models with random effects compensated for within-individual behavior over time. Temporal pathways were investigated by lagging independent variables (t - 1) in relation to our cigarette-use outcome at time (t).

RESULTS

Active social participation at (t - 1) was positively associated with smoking cessation at (t) (odds ratio [OR] = 1.39; 95% confidence interval [CI] [1.07-1.82]). Separating from one's spouse at (t - 1) increased risk for smoking relapse/initiation at (t) (OR = 6.63; 95% CI [1.70-28.89]). Conversely, being married protected against smoking cigarettes (OR = 1.87; 95% CI [1.15-3.04]). These associations held in our robustness checks.

CONCLUSIONS

Initial marital breakdown predicted a high risk of smoking relapse/initiation. The timing of this life event provides a critical window where adverse smoking behavior might occur. Conversely, the positive effects of active social participation on cigarette cessation remained consistent, its absence further predicting smoking relapse/initiation. Robustness of results confirms the important role that active participation has on cigarette smoking behavior. Group smoking cessation interventions could harness participatory elements to better achieve their goals.

IMPLICATIONS

By investigating temporal relationships between well-known smoking determinants and cigarette smoking outcomes, we identified that being "separated" (not "divorced") at time (t) predicted a higher risk of smoking relapse/initiation at (t). Tailored health messages could be employed to highlight the increased risk of cigarette smoking relapse/initiation during this stressful life event. Conversely, active social participation (a common social capital proxy) consistently predicted smoking cessation over time. Future group smoking cessation interventions could be designed explicitly to harness participatory elements to better achieve their goals.

摘要

引言

确定影响个人吸烟行为的因素仍是一个重大的公共卫生问题。本研究旨在探讨个人吸烟行为的变化,同时考虑包括社会资本在内的知名吸烟决定因素,假定社会资本的存在会减少吸烟行为。

方法

利用英国家庭追踪调查数据,创建了两个基线吸烟队列(“吸烟”和“不吸烟”)。对这个具有全国代表性样本(N = 8114,年龄在16 - 91岁之间)中的相同个体在2000年至2007年期间进行了四次访谈,以调查吸烟行为的变化。具有随机效应的逻辑回归模型补偿了个体随时间的行为变化。通过将自变量滞后一个时间点(t - 1)与我们在时间点(t)的吸烟结果相关联来研究时间路径。

结果

在时间点(t - 1)积极的社会参与与在时间点(t)戒烟呈正相关(优势比[OR] = 1.39;95%置信区间[CI] [1.07 - 1.82])。在时间点(t - 1)与配偶分居会增加在时间点(t)吸烟复发/开始吸烟的风险(OR = 6.63;95% CI [1.70 - 28.89])。相反,已婚则能预防吸烟(OR = 1.87;95% CI [1.15 - 3.04])。这些关联在我们的稳健性检验中仍然成立。

结论

初始婚姻破裂预示着吸烟复发/开始吸烟的高风险。这一生活事件的时机提供了一个关键窗口,在此期间可能会出现不良吸烟行为。相反,积极社会参与对戒烟的积极影响保持一致,缺乏这种参与则进一步预示着吸烟复发/开始吸烟。结果的稳健性证实了积极参与对吸烟行为的重要作用。群体戒烟干预措施可以利用参与性元素来更好地实现其目标。

启示

通过研究知名吸烟决定因素与吸烟结果之间的时间关系,我们发现,在时间点(t)处于“分居”(而非“离婚”)状态预示着在时间点(t)吸烟复发/开始吸烟的风险更高。可以采用针对性的健康信息来强调在这一压力较大的生活事件期间吸烟复发/开始吸烟风险的增加。相反,积极的社会参与(一种常见的社会资本替代指标)长期以来一直预示着戒烟。未来的群体戒烟干预措施可以明确设计,利用参与性元素来更好地实现其目标。

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