The Influence of Smoking Status on the Health Profiles of Older Chinese American Men

Chien Ching Li, Alicia K. Matthews, Xin Qi Dong, Melissa Simon

Publication Date: 01/01/2019

OBJECTIVE: To examine the influence of smoking status on the health profiles of community-dwelling older Chinese American men in the greater Chicago, IL, area.

DESIGN: This study utilized a cross-sectional study design to analyze data obtained from the larger Population Study of Chinese Elderly in Chicago (PINE).

SETTING: A population-based study conducted in Chicago. PARTICIPANTS: Baseline data from Chinese American men who participated in PINE (N = 1492).

MEASURES: Demographic characteristics measured included age, education years, marital status, income, health insurance coverage, and smoking pack-years. Self-reported smoking status included never smoker, current smoker, and former smoker. Health profile indicators included perceived health status, past 12-month changes in health, chronic medical conditions (heart diseases, stroke, cancer, diabetes, hypertension, high cholesterol, thyroid disease, and osteoarthritis), quality of life, and depression and anxiety. RESULTS: The mean age of the study sample was 72.5 years. Of the sample, 65% reported a smoking history, with 25.1% current smokers and 40.1% former smokers. Current smokers were younger, less educated, and uninsured. Former smokers had the poorest overall health profiles. Compared to former smokers, current smokers were less likely to have heart disease (odds ratio [OR] = 0.59; 95% confidence interval [CI] = 0.39-0.90), hypertension (OR = 0.54; 95% CI = 0.41-0.72), high cholesterol (OR = 0.74; 95% CI = 0.56-0.99), thyroid disease (OR = 0.44; 95% CI = 0.21-0.90), depression (rate ratio [RR] = 0.76; 95% CI = 0.58-0.99), and anxiety (RR = 0.72; 95% CI = 0.59-0.89), and they had fewer overall chronic medical conditions (RR = 0.79; 95% CI = 0.70-0.88) after controlling for demographic factors and smoking pack-year history. Compared to never smokers, former and current smokers reported poorer self-rated health (OR = 1.58; 95% CI = 1.11-2.26) and lower perceived quality of life (OR = 2.11; 95% CI = 1.04-4.29).

CONCLUSIONS: Consistent with prior research, smoking rates were elevated among this sample of older Chinese men. Counter to study hypotheses, former smokers had worse overall health. Study findings suggest the need for health promotion interventions for both current and former smokers. J Am Geriatr Soc 67:S577–S583, 2019.