Spousal Smoking and Incidence of First Stroke: The Health and Retirement Study
Background
Few prospective studies have investigated the relationship between spousal cigarette smoking and the risk of incident stroke.
Methods
Stroke-free participants in the U.S.-based Health and Retirement Study (HRS) aged ≥50 years and married at baseline (n=16,225) were followed, on average, 9.1 years between 1992 and 2006) for proxy or self-report of first stroke (1130 events). Participants were stratified by gender and own smoking status (never-smokers, former smokers, or current smokers), and the relationship assessed between the spouse's smoking status and the risk of incident stroke. Analyses were conducted in 2007 with Cox proportional hazards models. All models were adjusted for age; race; Hispanic ethnicity; Southern birthstate; parental education; paternal occupation class; years of education; baseline income; baseline wealth; obesity; overweight; alcohol use; and diagnosed hypertension, diabetes, or heart disease.
Results
Having a spouse who currently smoked was associated with an increased risk of first stroke among never-smokers (hazard ratio=1.42, 95% CI=1.05, 1.93) and former smokers (hazard ratio=1.72, 95% CI=1.33, 2.22). Former smokers married to current smokers had a stroke risk similar to respondents who themselves smoked.
Conclusions
Spousal smoking poses important stroke risks for never-smokers and former smokers. The health benefits of quitting smoking likely extend to both the individual smoker and his or her spouse.
aDepartment of Epidemiology, Mailman School of Public Health, New York, New York
bDepartment of Sociomedical Sciences, Mailman School of Public Health, New York, New York
cDepartment of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts
dDepartment of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
Address correspondence and reprint requests to: M. Maria Glymour, ScD, Department of Society Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston MA 02115.
ABSTRACT