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

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.

本研究旨在探讨老年人群社会隔离、孤独感与吸烟行为之间的关联。本研究为基于人群的横断面研究，共纳入986名60岁及以上的研究对象。研究数据取自巴西圣保罗州坎皮纳斯市2014/2015年度健康调查（ISACamp 2014/2015）。研究人员依据自变量估算了吸烟及戒烟的患病率，并采用卡方检验分析变量间的关联，检验水准设定为5%；同时通过简单泊松回归与多重泊松回归计算校正后的患病率比。吸烟与戒烟行为与多数反映客观社会隔离的变量均无显著关联。“时常或始终感到孤独”与更高的吸烟患病率显著相关（PR=2.25；95%置信区间CI：1.38-3.66）；而伴随自我报告情绪问题或常见精神障碍的孤独感，分别与吸烟行为呈强相关（PR=6.24；95%CI：1.37-28.47），与戒烟率降低呈显著关联（PR=0.46；95%CI：0.28-0.77）。本研究结果显示，孤独感作为一种社会心理因素与老年人的烟草使用行为相关，且会阻碍其戒烟进程，凸显了情绪问题在该关联中的重要作用。