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.

Trends in social inequality in self-reported health in the Netherlands; does infant mortality in year of birth as a cohort indicator matter?

In this article, we study trends in self-reported health (general health and chronic conditions) and health inequality in the Netherlands between 1974 and 1998 using an age-period-cohort framework. We answer two questions: (1) to what extent can trends in self-reported health be explained by the current macro-context (period effect) and by infant mortality in year of birth (cohort effect)? And (2) do the effects of period and cohort differ for educational groups? Health indicators are self-reported poor health and chronic conditions. The use of 26 Dutch cross-sectional surveys makes it possible to estimate largely unbiased effects of period and cohort simultaneously (controlled for age effects) and thus to adequately describe trends in social inequality in health. Our results give rise to four conclusions. First, for men poor health has been more or less stable, for women there has been an increase. The prevalence of chronic conditions has increased for both sexes. Second, adding cohort specific experiences to a model including age and period effects is only relevant for women’s poor health. Decreasing infant mortality in year of birth leads to better health and consequently the period effect initially found for women appears to be slightly underestimated. Third, we found no trends in social inequalities in self-reported health due to period effects. Fourth, our analyses do show socially unequal trends in health as a result of cohort specific experiences. Contrary to our hypothesis, we found that decreased infant mortality in year of birth makes for a stronger impact of educational differences on self-reported poor health. Concerning chronic conditions no trends for educational groups were found.