How important are parents and partners for smoking cessation in adulthood? An event history analysis

Background. The aim of this study is to assess the effect of parental and partner’s education and smoking behavior on an individual’s chance of smoking cessation over the life course. Methods. Self-reported life histories of smoking behavior, education, and relationships were recorded in face-to-face interviews with a random general-population sample of 850 respondents and their partners (if present). The data were collected in 2000. A discrete-time event history model is applied in the analyses of cessation over the life course. Results. Parents’ education and smoking behavior (during adolescence) and partners’ education have no significant influence on cessation. Living with an ex-smoker or never-smoker increases the likelihood of quitting, compared to being single or living with a partner who smokes. Respondents whose partners were ex-smokers are almost five times more likely to quit smoking than single respondents. They are almost twice as likely to quit compared to those living with a never-smoker. Conclusions. The difference between having and not having a partner seems as important for cessation as the difference between having a partner who smokes, has never smoked, or has stopped smoking. An ex-smoking partner stimulates cessation more than a partner who has never smoked. Studies into cessation should take into account partners’ smoking histories.

Partner’s and own education: does who you live with matter for self-assessed health, smoking and excessive alcohol consumption?

This study analyses the importance of partner status and partner’s education, adjusted for own education, on selfassessed health, smoking and excessive alcohol consumption. The relationship between socio-economic factors and health-related outcomes is traditionally studied from an individual perspective. Recently, applying social–ecological models that include socio-economic factors on various social levels is becoming popular. We argue that partners are an important influence on individual health and health-related behaviour at the household level. Therefore, we include partners in the analysis of educational health inequalities. Using data of almost 40,000 individuals (with almost 15,000 Dutch cohabiting couples), aged 25–74 years, who participated in the Netherlands Health Interview Survey between 1989 and 1996, we test hypotheses on the importance of own and partner’s education. We apply advanced logistic regression models that are especially suitable for studying the relative influence of partners’ education. Controlled for own education, partner’s education is significantly associated with self-assessed health and smoking, for men and women. Accounting for both partners’ education the social gradient in self-assessed health and smoking is steeper than based on own or partner’s education alone. The social gradient in health is underestimated by not considering partner’s education, especially for women.

Psychiatric morbidity and subsequent divorce : a couple-level register-based study in Finland

Purpose Studies that assess the role of mental health for the risk of divorce are scarce and mostly rely on individual-level data, although divorce is a couple-level phenomenon. Using data on couples, we examine the effects of both spouses’ psychiatric morbidity on the risk of divorce, and whether socio-demographic factors affect these associations. Methods We followed 96,222 Finnish married couples for 6 years using register-based data on both spouses and their household. New incidence of psychiatric morbidity and subsequent divorce was identified from dates of prescription medication purchases and hospital admissions, and dates of registered divorce. Socio-demographic factors were measured annually for both spouses and their household. The effect of incident psychiatric morbidity on divorce risk was analyzed using Cox regression. Results Psychiatric morbidity in men increased the age-adjusted risk of divorce more than twofold and in women nearly twofold. The risk of divorce was particularly pronounced immediately after new incidence of psychiatric morbidity, before settling to a persistently high level. Psychiatric morbidity in both spouses increased the risk of divorce almost threefold. Adjustment for socio-economic factors had little effect on these associations. Conclusions Psychiatric morbidity is a persistent risk factor of divorce. The risk is larger when both spouses experience psychiatric morbidity compared to only one spouse. The findings are consistent with the idea that poor relationship quality and dissatisfaction in couples suffering from mental health problems have long-term consequences for marital stability. Treatment of psychiatric morbidity should not focus only on the individual but on couple-level dynamics.Peer reviewe

Divorce and subsequent increase in uptake of antidepressant medication : a Finnish registry-based study on couple versus individual effects

Background: There is an average negative mental health effect for individuals who experience divorce. Little is known whether the pattern of such divorce effects varies within couples. We study whether the husband and wife experience similar harmful effects of divorce, whether they experience opposite effects, or whether divorce effects are purely individual. Methods: We use Finnish registry data to compare changes over a period of 5 years in antidepressant use of husbands and wives from 4,558 divorcing couples to 108,637 continuously married pairs aged 40-64, all of whom were healthy at baseline. Results: In the period three years before and after divorce antidepressant use increases substantially. However, the likelihood of uptake of antidepressant medication during this process of divorce by one partner appears to be independent of medication uptake in the other partner. In contrast, among continuously married couples there is a clear pattern of convergence: If one partner starts to use antidepressants this increases the likelihood of uptake of antidepressant medication in the other partner. Conclusions: Our findings suggest that divorce effects on antidepressant use are individual and show no pattern of either convergence or divergence at the level of the couple. The increased incidence of antidepressant use associated with divorce occurs in individuals independent of what happens to their ex-partner.Peer reviewe

Global Family Change: Persistent Diversity with Development

This paper provides a broad empirical overview of the relationship between family change and socio-economic development drawing on 30+ years of Demographic and Health Survey data from 3.5 million respondents across 84 low- and middle-income countries (LMICs). We conduct two sets of analyses. First, we document global and regional-level associations between the Human Development Index (HDI) and novel indicators reflecting multidimensional family change. Second, we use methods from the growth convergence literature to examine whether – and in which domains – there is evidence of cross-country convergence in family indicators over levels of development. We show that families in LMICs have transformed in multiple ways, changing differently across domains, world regions, and genders. Fertility, intra-couple decision-making, and women’s life-course timing indicators are strongly associated with HDI, yet cross-country convergence is limited to the latter domain. Marriage, cohabitation, household structure, and men’s life-course timing indicators are more weakly associated with HDI, and span a broad spectrum of convergence dynamics ranging from divergence to modest convergence. We describe this scenario as “persistent diversity with development,” and shed light on the underlying regional heterogeneity – driven primarily by sub-Saharan Africa

Twinning across the Developing World

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