Prevalence of current smoking and associated factors in older adults in Brazil

This cross-sectional study utilized data from the ELSI-Brazil study, encompassing 9,412 adults aged 50 years or over. A multivariate model using Poisson regression with a robust estimator was employed, estimating prevalence ratios and their 95% confidence intervals.

RESULTS:

The prevalence of current smoking was 17.04%. It was positively and independently associated with male gender, age up to 62 years, living without a partner, illiteracy, chronic obstructive pulmonary disease, depression, poor or very poor sleep quality, and alcohol intake more than once a month. Conversely, systemic arterial hypertension, hypercholesterolemia, diabetes mellitus, and repetitive strain injuries showed an inverse and independent association with current smoking.

CONCLUSION:

The prevalence of current smoking among adults over 50 years old in Brazil was approximately 17%, with associations found with certain sociodemographic conditions and self-reported comorbidities.

KEYWORDS:
Smoking; Older adults; Chronic disease; Aging; Tobacco

Variables		Smoking
Variables		n	%	PR_c^* * PRc: Crude prevalence ratio.	95%CI^ 95%CI: 95% confidence interval.	p-value
First level—sociodemographic
Gender
	Male	843	20.6	1.04	1.03–1.05	<0.001
	Female	761	14.4	1.00	1.03–1.05	<0.001
Skin color
	White	564	15.7	1.00	1.01–1.03	0.012
	Not white	972	17.7	1.02	1.01–1.03	0.012
Age (median)
	Over 62 years	566	12.7	1.00	1.04–1.06	<0.001
	Up to 62 years	1.038	21.0	1.05	1.04–1.06	<0.001
Education
	More than 8 years schooling completed	341	14.8	1.00	1.01–1.03	0.300
	From 1 to 8 years schooling completed	965	17.5	1.02	1.01–1.03	0.042
	Illiterate	284	18.6	1.03	1.01–1.04	<0.001
Marital status
	With partner	845	15.5	1.00	1.01–1.03	<0.001
	No partner	759	19.1	1.02	1.01–1.03	<0.001
Remunerated activity
	No	1.043	15.8	1.00	1.01–1.03	<0.001
	Yes	561	19.9	1.02	1.01–1.03	<0.001
Second level—comorbidities
Systemic arterial hypertension
	No	910	20.8	1.00	0.95–0.97	<0.001
	Yes	687	13.7	0.96	0.95–0.97	<0.001
Hypercholesterolemia
	No	1.182	18.4	1.00	0.96–0.98	<0.001
	Yes	403	13.9	0.97	0.96–0.98	<0.001
Asthma
	No	1.514	17.0	1.00	0.98–1.02	0.587
	Yes	85	17.9	1.01	0.98–1.02	0.587
Chronic obstructive pulmonary disease
	No	1.478	16.7	1.00	1.01–1.04	0.001
	Yes	121	22.2	1.03	1.01–1.04	0.001
Acute myocardial infarction
	No	1.502	17.0	1.00	0.98–1.02	0.549
	Yes	100	18.0	1.01	0.98–1.02	0.549
Cardiac insufficiency
	No	1.508	17.4	1.00	0.97–1.02	0.005
	Yes	89	13.1	0.98	0.97–1.02	0.005
Stroke
	No	1.521	17.2	1.00	0.98–1.01	0.275
	Yes	82	15.3	0.99	0.98–1.01	0.275
Cancer
	No	1.534	17.3	1.00	0.95–0.97	0.008
	Yes	64	12.7	0.97	0.95–0.97	0.008
Diabetes mellitus
	No	1.391	17.8	1.00	0.96–0.99	<0.001
	Yes	201	13.2	0.97	0.96–0.99	<0.001
Depression
	No	1.263	16.5	1.00	1.01–1.03	0.002
	Yes	335	19.6	1.02	1.01–1.03	0.002
Alzheimer's disease
	No	1.593	17.1	1.00	0.92–0.99	0.040
	Yes	7	8.5	0.95	0.92–0.99	0.040
Parkinson's disease
	No	1.588	17.0	1.00	0.96–1.06	0.715
	Yes	12	18.8	1.01	0.96–1.06	0.715
Repetitive strain injury
	No	487	19.9	1.00	0.97–0.99	<0.001
	Yes	1.075	16.3	0.98	0.97–0.99	<0.001
Sleep quality
	Regular/good/very good	1.246	16.3	1.00	1.01–1.03	<0.001
	Bad/very bad	355	20.2	1.02	1.01–1.03	<0.001
Alcohol intake
	No	939	13.6	1.00
	Once a month	127	23.3	1.03	1.01–1.05	0.032
	More than once a month	535	27.4	1.08	1.07–1.09	<0.001

Variables		Current smoking
Variables		PR_a^* * PRa: adjusted prevalence ratio.	95%CI^ 95%CI: 95% confidence interval.	p-value
First level—sociodemographic
Gender
	Female	1.00	1.02–1.04	<0.001
	Male	1.03	1.02–1.04	<0.001
Age (median)
	Over 62 years old	1.00	1.03–1.05	<0.001
	Up to 62 years	1.04	1.03–1.05	<0.001
Marital status
	With partner	1.00	1.03–1.05	<0.001
	No partner	1.04	1.03–1.05	<0.001
Education
	More than 8 schooling completed	1.00
	From 1 to 8 schooling completed	1.01	0.99–1.03	0.081
	Illiterate	1.04	1.02–1.06	<0.001
Second level—self-reported comorbidities
Systemic arterial hypertension
	No	1.00	0.96–0.98	<0.001
	Yes	0.97	0.96–0.98	<0.001
Hypercholesterolemia
	No	1.00	0.97–0.99	<0.001
	Yes	0.98	0.97–0.99	<0.001
Chronic obstructive pulmonary disease
	No	1.00	1.01–1.05	0.011
	Yes	1.03	1.01–1.05	0.011
Cancer
	No	1.00	0.97–1.00	0.061
	Yes	0.98	0.97–1.00	0.061
Diabetes mellitus
	No	1.00	0.97–0.99	0.040
	Yes	0.98	0.97–0.99	0.040
Depression
	No	1.00	1.01–1.04	<0.001
	Yes	1.03	1.01–1.04	<0.001
Repetitive strain injury
	No	1.00	0.96–0.99	0.004
	Yes	0.98	0.96–0.99	0.004
Sleep quality
	Regular/good/very good	1.00	1.01–1.03	0.001
	Bad/very bad	1.02	1.01–1.03	0.001
Alcohol intake
	No	1.00
	Once a month	1.02	0.99–1.04	0.071
	More than once a month	1.07	1.05–1.09	<0.001

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] *Corresponding author:
josearth9@gmail.com