Examining the Association of Social Isolation and Smoking in Older Adults

Abstract

Background: Tobacco use remains a leading cause of preventable death among older adults, but few studies have examined social isolation as a risk factor for smoking in US. older adults. Methods: Using National Health and Aging Trends Study (NHATS) data, we conducted multivariate analyses of smoking in a sample of 8136 adults ages 65 and older. Results: Social isolation and severe isolation were associated with higher odds of smoking (OR: 2.48 and 5.48, p = 0.002 and p < 0.001). Individuals with mild (OR: 1.46, p = 0.006), moderate (OR: 1.80, p = 0.001), or severe (OR: 3.05, p = 0.001) symptoms of depression/anxiety also had higher odds of smoking. Conclusions: Social isolation is a significant risk factor for smoking in US older adults. Further research is needed to support the development of interventions to reduce social isolation and smoking behavior in older adults.

Figure 1.. Forest Plot of Adjusted Odds Ratios for Covariates on Current Smoking Status

Notes. Sample size: N = 8,143; OR: Odds ratios (adjusted in the multivariable analysis); Depression/anxiety covariates were measured using the 4-item Patient Health Questionnaire (PHQ-4); Wave 5 participants were respondents included in the 2015 replenishment sample, or who were part of the original 2011 cohort but who did not have data relevant to this study available until 2015; Reference groups include not socially isolated, normal depression/anxiety, Wave 1 participants, White/non-Hispanic, male, and no Medicaid.