Transition to retirement impact on smoking habit: results from a longitudinal analysis within the Survey of Health, Ageing and Retirement in Europe (SHARE) project

Abstract

Background: In an ageing society, retirement impacts on behavioural risk factors and health outcomes should be carefully assessed. Scant evidence exists from longitudinal studies on the short- and long-term consequences of the transition to retirement on smoking habit.

Methods: We conducted a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) data from 27 European countries plus Israel collected in 2004-2020. To estimate relative risks (RR) and corresponding 95% confidence intervals (CI) for smoking status and intensity at seven time periods before and after retirement, we fitted adjusted generalised estimating equation (GEE) models for repeated measures.

Results: We selected a cohort of 8998 individuals employed at baseline and retired at follow-up (median follow-up time: 9 years; maximum: 16 years). As compared to the year of retirement, the RR of smoking was 1.59 (95% CI 1.44-1.76) at 10 years or more before retirement, 1.35 (95% CI 1.25-1.46) from 5 to 9 years before retirement, and 1.18 (95% CI 1.10-1.27) from 1 to 4 years before retirement. Smoking steadily decreased after retirement, being 0.94 (95% CI 0.87-1.01) from 1 to 4 years after retirement, 0.76 (95% CI 0.69-0.84) from 5 to 9 years, and 0.58 (95% CI 0.46-0.74) 10 years or more after retirement. In smokers, the estimated number of cigarettes smoked/day decreased from about 27 cigarettes/day at 10 years or more before retirement to 9 cigarettes/day at 10 years or more after retirement (p trend < 0.001).

Conclusion: Longitudinal data suggest that lifestyles might favourably change with retirement. Further studies are needed to direct healthy ageing promotion policies better.

Keywords: Life-course transitions; Longitudinal studies; Retirement; SHARE data; Smoking.

Fig. 1

Flowchart of the study cohort selection

Fig. 2

Forest plot of the relative risk (RR)* and corresponding 95% confidence intervals (CI) for the current smoking status (yes vs no) at seven different periods before and after retirement (reference category: the year of retirement). *Estimates were obtained from a GEE model for repeated measures, adjusted by geographical area, sex, age (continuous), marital status (married/registered partnership, divorced/widowed, and never married), educational level (low, intermediate, high), occupation (ISCO major categories) as baseline covariates, and the presence of at least one chronic disease (yes, no) as time-varying covariate

Fig. 3

Predicted values* and 95% confidence intervals (error bars) of the number of cigarettes smoked per day at different time periods before and after retirement, among the ever smokers over the study period. *Estimated through a GEE model for repeated measures, adjusted by the following baseline covariates: geographical area, sex, age (continuous), marital status (married/registered partnership, divorced/widowed, and never married), educational level (low, intermediate, high), occupation (ISCO major categories), and the presence of at least one chronic disease (yes, no) as a time-varying covariate