Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil

Abstract

This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. “Often or always” loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.

Exploring Loneliness, Trust, and Psychosocial Meanings Among Primary Care Attendees: A Cross-Sectional Study From a General Practice Setting in Crete, Greece

“…According to the present data, loneliness affects people’s behavior, specifically behaviors that may be involved in the deterioration of physical health, such as smoking, drinking, lack of physical activity, and increased body weight. There is evidence that loneliness is associated with smoking or lower possibilities of quitting smoking, especially when loneliness co-exists with self-reported emotional problems [ 13 ], while lack of close friends and loneliness have also been related to smoking [ 49 ]. Studying behavioral risk factors is also challenging, although their separate effects on chronic disease occurrence [ 23 , 50 ] and all-cause mortality [ 51 ] are already known.…”

“…More specifically, loneliness is related to a higher prevalence of being a smoker and a lower prevalence of quitting smoking in older adults [ 13 ], while those who start smoking present higher levels of loneliness [ 14 ]. A similar relationship between smoking and loneliness is reported among young adults [ 15 ].…”

A Middle-Range Theory of Social Isolation in Chronic Illness

“…Self-care is also negatively associated with subjective social isolation (i.e., loneliness); for example, lonely people have been found to exhibit eating disorders, be more likely to smoke [ 50 ], and inconsistent in taking prescribed medications compared to those who are not lonely [ 51 ]. We already know that loneliness inhibits socialization; however, the effect of loneliness on self-care behaviors may also be due to a compromised self-regulation of emotion, which diminishes the likelihood of specific lifestyle behaviors such as physical activity [ 52 ].…”