The emergence of cohabitation as a first union and its later stability: the case of Hungarian women

With the transition of the 1990s in the countries of Central and Eastern Europe, the demographic behavior of their populations has changed drastically. This paper focuses on Hungary where some of these developments like falling marriage rates were evident even before 1990. We examine the emergence of cohabitation as a first union and the stability of such relationships. Are they rather transformed into marriage or do they end in dissolution? How long do Hungarian woman stay in these unions? In addition to some descriptive statistics we apply event history analysis because this allows us to study the impact of individual-level characteristics on such choices. The data used is the Hungarian Generations and Gender Survey collected around November 2001. The analysis shows that there are marked differences in behavior between periods and that factors like pregnancy or employment do influence the decision for cohabitation as well as its further development.Hungary

A cross-sectional investigation of softening indicators among South African smokers : results from the South African Social Attitudes Survey between 2007 and 2018

DATA AVAILABILITY STATEMENT : Data are available on reasonable request. Requests will be considered on a case-by-case basis.Recent studies have shown softening among smokers in different countries and in different population groups i.e., as smoking prevalence declined remaining smokers made more quit attempts and smoked fewer cigarettes per day (CPD), as opposed to hardening. We examined tobacco use-related cross-sectional data from five waves of the South African Social Attitudes Survey (SASAS 2007–2018, N = 14,822). Accounting for the SASAS’s complex survey design, we ran logistic and linear regressions for smoking prevalence, and for the following indicators of softening: plans to quit smoking within a month, time to first cigarette (5 min, TTFC) and cigarettes smoked per day (CPD). We controlled for survey wave, age, sex, race, marital status, educational level and urban/rural residence. Smoking prevalence remained stable from 2007 (20.7%) to 2018 (22.2%) in the overall population of smokers (p = 0.197), and within sex and race group of smokers. In the adjusted model, there was a significant decline in CPD over time, 0.12 cigarettes per year. There was also a significant decrease in TTFC among males over time. Among women, CPD declined significantly by 0.32 cigarettes per year. The proportion of Asians/Indians planning to quit also decreased over time. South African smokers do not consistently show significant change in the softening indicators overall. Stronger tobacco control policies and better-tailored smoking cessation interventions are needed to achieve a significant decrease in smoking prevalence across sex and other subpopulations in South Africa.The African Capacity Building Foundation were funded by the South African Medical Research Council.https://www.elsevier.com/locate/pmedrhj2023School of Health Systems and Public Health (SHSPH

Potential health gains and health losses in eleven EU countries attainable through feasible prevalences of the life-style related risk factors alcohol, BMI, and smoking: a quantitative health impact assessment

Background: Influencing the life-style risk-factors alcohol, body mass index (BMI), and smoking is an European Union (EU) wide objective of public health policy. The population-level health effects of these risk-factors depend on population specific characteristics and are difficult to quantify without dynamic population health models. Methods: For eleven countries-approx. 80 % of the EU-27 population-we used evidence from the publicly available DYNAMO-HIA data-set. For each country the age- and sex-specific risk-factor prevalence and the incidence, prevalence, and excess mortality of nine chronic diseases are utilized; including the corresponding relative risks linking risk-factor exposure causally to disease incidence and all-cause mortality. Applying the DYNAMO-HIA tool, we dynamically project the country-wise potential health gains and losses using feasible, i.e. observed elsewhere, risk-factor prevalence rates as benchmarks. The effects of the 'worst practice', ' best practice', and the currently observed risk-factor prevalence on population health are quantified and expected changes in life expectancy, morbidity-free life years, disease cases, and cumulative mortality are reported. Results: Applying the best practice smoking prevalence yields the largest gains in life expectancy with 0.4 years for males and 0.3 year for females (approx. 332,950 and 274,200 deaths postponed, respectively) while the worst practice smoking prevalence also leads to the largest losses with 0.7 years for males and 0.9 year for females (approx. 609,400 and 710,550 lives lost, respectively). Comparing morbidity-free life years, the best practice smoking prevalence shows the highest gains for males with 0.4 years (342,800 less disease cases), whereas for females the best practice BMI prevalence yields the largest gains with 0.7 years (1,075,200 less disease cases). Conclusion: Smoking is still the risk-factor with the largest potential health gains. BMI, however, has comparatively large effects on morbidity. Future research should aim to improve knowledge of how policies can influence and shape individual and aggregated life-style-related risk-factor behavior

How Can Inequalities in Mortality Be Reduced? A Quantitative Analysis of 6 Risk Factors in 21 European Populations

Peer reviewe

Comparison of Tobacco Control Scenarios: Quantifying Estimates of Long-Term Health Impact Using the DYNAMO-HIA Modeling Tool

There are several types of tobacco control interventions/policies which can change future smoking exposure. The most basic intervention types are 1) smoking cessation interventions 2) preventing smoking initiation and 3) implementation of a nationwide policy affecting quitters and starters simultaneously. The possibility for dynamic quantification of such different interventions is key for comparing the timing and size of their effects

DYNAMO-HIA–A Dynamic Modeling Tool for Generic Health Impact Assessments

Currently, no standard tool is publicly available that allows researchers or policy-makers to quantify the impact of policies using epidemiological evidence within the causal framework of Health Impact Assessment (HIA). A standard tool should comply with three technical criteria (real-life population, dynamic projection, explicit risk-factor states) and three usability criteria (modest data requirements, rich model output, generally accessible) to be useful in the applied setting of HIA. With DYNAMO-HIA (Dynamic Modeling for Health Impact Assessment), we introduce such a generic software tool specifically designed to facilitate quantification in the assessment of the health impacts of policies

Occupational Class Inequalities in All-Cause and Cause-Specific Mortality among Middle-Aged Men in 14 European Populations during the Early 2000s

Peer reviewe

Softening Among U.S. Smokers With Psychological Distress: More Quit Attempts and Lower Consumption as Smoking Drops.

IntroductionIt has been argued that as smoking prevalence declines, the remaining smokers represent a "hard core" who are unwilling or unable to quit, a process known as hardening. However, as recently shown, the general smoking population is softening not hardening (i.e., as prevalence falls, more quit attempts and lower consumption among continuing smokers). People with psychological distress smoke more, so they may represent hard-core smokers.MethodsUsing cross-sectional time series analysis, in 2016-2017 changes in quit attempts and cigarette consumption were evaluated over 19 years among smokers with serious psychological distress (Kessler-6 score ≥13) based on the National Health Interview Survey (1997-2015), controlling for sociodemographic variables.ResultsPeople with psychological distress had higher smoking prevalence and consumed more cigarettes/day than people without distress. The percentage of those with at least one quit attempt was higher among those with psychological distress. The increase in quit attempts over time was similar among smokers in each of the distress levels. For every 10 years, the OR of a quit attempt increased by a factor of 1.13 (95% CI=1.02, 1.24, p<0.05). Consumption declined by 3.35 (95% CI= -3.94, -2.75, p<0.01) cigarettes/day for those with serious psychological distress.ConclusionsAlthough smoking more heavily than the general population, smokers with psychological distress, like the general population, are softening over time. To improve health outcomes and increase health equity, tobacco control policies should continue moving all subgroups of smokers down these softening curves, while simultaneously incorporating appropriately tailored quitting help into mental health settings