Lifelong smoking trajectories of Northern Finns are characterized by sociodemographic and lifestyle differences in a 46-year follow-up

Abstract Smoking remains among the leading causes of mortality worldwide. Obtaining a comprehensive understanding of a population’s smoking behaviour is essential for tobacco control. Here, we aim to characterize lifelong smoking patterns and explore underlying sociodemographic and lifestyle factors in a population-based birth cohort population followed up for 46 years. Our analysis is based on 5797 individuals from the Northern Finland Birth Cohort 1966 who self-reported their tobacco smoking behaviour at the ages of 14, 31 and 46. Data on sex, education, employment, body mass index, physical activity, alcohol consumption, and substance addiction were also collected at the follow-ups. We profile each individual’s annual smoking history from the age of 5 to 47, and conduct a latent class trajectory analysis on the data. We then characterize the identified smoking trajectory classes in terms of the background variables, and compare the heaviest smokers with other classes in order to reveal specific predictors of non-smoking and discontinued smoking. Six smoking trajectories are identified in our sample: never-smokers (class size 41.0%), youth smokers (12.6%), young adult quitters (10.8%), late adult quitters (10.5%), late starters (4.3%), and lifetime smokers (20.7%). Smoking is generally associated with male sex, lower socioeconomic status and unhealthier lifestyle. Multivariable between-class comparisons identify unemployment (odds ratio [OR] 1.28–1.45) and physical inactivity (OR 1.20–1.52) as significant predictors of lifetime smoking relative to any other class. Female sex increases the odds of never-smoking and youth smoking (OR 1.29–1.33), and male sex increases the odds of adult quitting (OR 1.30–1.41), relative to lifetime smoking. We expect future initiatives to benefit from our data by exploiting the identified predictors as direct targets of intervention, or as a means of identifying individuals who may benefit from such interventions.

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Declining Incident Dementia Rates Across Four Population-Based Birth Cohorts

The Journals of Gerontology Series A ◽

10.1093/gerona/gly236 ◽

2018 ◽

Vol 74 (9) ◽

pp. 1439-1445 ◽

Cited By ~ 3

Author(s):

Kevin J Sullivan ◽

Hiroko H Dodge ◽

Tiffany F Hughes ◽

Chung-Chou H Chang ◽

Xinmei Zhu ◽

...

Keyword(s):

Birth Cohort ◽

Sex Education ◽

Healthy Aging ◽

Epidemiological Studies ◽

Population Based ◽

Incidence Rates ◽

Birth Cohorts ◽

Clinical Dementia Rating ◽

Or Education ◽

Incident Dementia

Abstract Background Incidence rates of dementia appear to be declining in high-income countries according to several large epidemiological studies. We aimed to describe declining incident dementia rates across successive birth cohorts in a U.S. population-based sample and to explore the influences of sex and education on these trends. Methods We pooled data from two community-sampled prospective cohort studies with similar study aims and contiguous sampling regions: the Monongahela Valley Independent Elders Survey (1987–2001) and the Monongahela-Youghiogheny Healthy Aging Team (2006–Ongoing). We identified four decade-long birth cohorts spanning birth years 1902–1941. In an analysis sample of 3,010 participants (61% women, mean baseline age = 75.7 years, mean follow-up = 7.1 years), we identified 257 cases of incident dementia indicated by a Clinical Dementia Rating of 1.0 or higher. We used Poisson regression to model incident dementia rates by birth cohort, age, sex, education, and interactions of Sex × Cohort and Sex × Education. We further examined whether cohort effects varied by education, testing a Cohort × Education interaction and stratifying the models by education. Results Compared to the earliest birth cohort (1902–1911), each subsequent cohort had a significantly lower incident dementia rate (1912–1921: incidence rate ratio [IRR] = 0.655, 95% confidence interval [95% CI] = 0.477–0.899; 1922–1931: IRR = 0.387, 95% CI = 0.265–0.564; 1932–1941: IRR = 0.233, 95% CI = 0.121–0.449). We observed no significant interactions of either sex or education with birth cohort. Conclusions A decline in incident dementia rates was observed across successive birth cohorts independent of sex, education, and age.

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Maternal smoking behaviour across the first two pregnancies and small for gestational age birth: Analysis of the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the South of England

PLoS ONE ◽

10.1371/journal.pone.0260134 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0260134

Author(s):

Elizabeth J. Taylor ◽

Pia Doh ◽

Nida Ziauddeen ◽

Keith M. Godfrey ◽

Ann Berrington ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Maternal Smoking ◽

Population Based ◽

Smoking Behaviour ◽

Adverse Birth Outcomes ◽

Full Sample ◽

Healthcare Data ◽

Increased Risk ◽

Never Smokers

Maternal smoking is established to cause adverse birth outcomes, but evidence considering maternal smoking change across successive pregnancies is sparse. We examined the association between self-reported maternal smoking during and between the first two pregnancies with the odds of small for gestational age (SGA) birth (<10th percentile) in the second infant. Records for the first two pregnancies for 16791 women within the SLOPE (Studying Lifecourse Obesity PrEdictors) study were analysed. This is a population-based cohort of prospectively collected anonymised antenatal and birth healthcare data (2003–2018) in Hampshire, UK. Logistic regression was used to relate maternal smoking change to the odds of SGA birth in the second infant. In the full sample, compared to never smokers, mothers smoking at the start of the first pregnancy had higher odds of SGA birth in the second pregnancy even where they stopped smoking before the first antenatal appointment for the second pregnancy (adjusted odds ratio (aOR) 1.50 [95% confidence interval 1.10, 2.03]). If a mother was not a smoker at the first antenatal appointment for either her first or her second pregnancy, but smoked later in her first pregnancy or between pregnancies, there was no evidence of increased risk of SGA birth in the second pregnancy compared to never smokers. A mother who smoked ten or more cigarettes a day at the start of both of her first two pregnancies had the highest odds of SGA birth (3.54 [2.55, 4.92]). Women who were not smoking at the start of the first pregnancy but who subsequently resumed/began smoking and smoked at the start of their second pregnancy, also had higher odds (2.11 [1.51, 2.95]) than never smokers. Smoking in the first pregnancy was associated with SGA birth in the second pregnancy, even if the mother quit by the confirmation of her second pregnancy.

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Children With ADHD Are at Risk for a Broad Array of Adverse Adult Outcomes That Cross Functional Domains: Results From a Population-Based Birth Cohort Study

Journal of Attention Disorders ◽

10.1177/1087054720964578 ◽

2020 ◽

pp. 108705472096457

Author(s):

Elizabeth B. Harstad ◽

Slavica Katusic ◽

Georgios Sideridis ◽

Amy L. Weaver ◽

Robert G. Voigt ◽

...

Keyword(s):

At Risk ◽

Birth Cohort ◽

Latent Class ◽

Population Based ◽

Birth Cohort Study ◽

Adult Outcomes ◽

Children With Adhd ◽

Childhood Adhd ◽

The Poor ◽

Broad Array

Objective: To identify patterns (“classes”) of outcomes for adults with and without childhood ADHD. Method: Subjects were 232 childhood ADHD cases and 335 non-ADHD referents from a 1976 to 1982 birth cohort. We used latent class analyses to identify classes based on a broad array of adult psychosocial outcomes and determined the proportion of subjects with childhood ADHD within each class. Results: A three class solution provided optimal model fit; classes were termed “good,” “intermediate,” and “poor” functioning. Subjects with childhood ADHD comprised 62.8% of the “poor,” 53.5% of the “intermediate,” and 24.9% of the “good” functioning class. The “poor” functioning class was distinguished by increased likelihood of legal trouble and substance use disorders and included more individuals with childhood ADHD and psychiatric disorder than the “intermediate” class (45.5% vs. 30.6%). Conclusion: Children with ADHD are at risk for adverse adult outcomes in multiple domains and co-morbid childhood psychiatric disorders increase risk.

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Mild anemia and 11- to 15-year mortality risk in young-old and old-old: Results from two population-based cohort studies

PLoS ONE ◽

10.1371/journal.pone.0261899 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261899

Author(s):

Alessia A. Galbussera ◽

Sara Mandelli ◽

Stefano Rosso ◽

Roberto Zanetti ◽

Marianna Rossi ◽

...

Keyword(s):

Sex Education ◽

Mortality Risk ◽

Age Groups ◽

Population Based ◽

Adverse Outcomes ◽

Smoking History ◽

Time Varying ◽

Mild Anemia ◽

Time Varying Covariates ◽

Young Old

Background Mild anemia is a frequent although often overlooked finding in old age. Nevertheless, in recent years anemia has been linked to several adverse outcomes in the elderly population. Objective of the study was to investigate the association of mild anemia (hemoglobin concentrations: 10.0–11.9/12.9 g/dL in women/men) with all-cause mortality over 11–15 years and the effect of change in anemia status on mortality in young-old (65–84 years) and old-old (80+ years). Methods The Health and Anemia and Monzino 80-plus are two door-to-door, prospective population-based studies that included residents aged 65-plus years in Biella municipality and 80-plus years in Varese province, Italy. No exclusion criteria were used. Results Among 4,494 young-old and 1,842 old-old, mortality risk over 15/11 years was significantly higher in individuals with mild anemia compared with those without (young-old: fully-adjusted HR: 1.35, 95%CI, 1.15–1.58; old-old: fully-adjusted HR: 1.28, 95%CI, 1.14–1.44). Results were similar in the disease-free subpopulation (age, sex, education, smoking history, and alcohol consumption adjusted HR: 1.54, 95%CI, 1.02–2.34). Both age groups showed a dose-response relationship between anemia severity and mortality (P for trend <0.0001). Mortality risk was significantly associated with chronic disease and chronic kidney disease mild anemia in both age groups, and with vitamin B12/folate deficiency and unexplained mild anemia in young-old. In participants with two hemoglobin determinations, seven-year mortality risk was significantly higher in incident and persistent anemic cases compared to constant non-anemic individuals in both age groups. In participants without anemia at baseline also hemoglobin decline was significantly associated with an increased mortality risk over seven years in both young-old and old-old. Limited to the Monzino 80-plus study, the association remained significant also when the risk was further adjusted also for time-varying covariates and time-varying anemia status over time. Conclusions Findings from these two large prospective population-based studies consistently suggest an independent, long-term impact of mild anemia on survival at older ages.

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Clustering of asthma and related comorbidities and their association with maternal health during pregnancy: evidence from an Australian birth cohort

BMC Public Health ◽

10.1186/s12889-021-11997-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kabir Ahmad ◽

Enamul Kabir ◽

Gail M. Ormsby ◽

Rasheda Khanam

Keyword(s):

Birth Cohort ◽

Latent Class ◽

Multinomial Logistic Regression ◽

Asthma Severity ◽

Population Based ◽

Health Condition ◽

Health Conditions ◽

Vulnerable Groups ◽

Children With Asthma ◽

Outcome Differences

Abstract Background The population-based classification of asthma severity is varied and needs further classification. This study identified clusters of asthma and related comorbidities of Australian children aged 12–13 years; determined health outcome differences among clusters; and investigated the associations between maternal asthma and other health conditions during pregnancy and the children’s clustered groups. Methods Participants were 1777 children in the birth cohort of the Longitudinal Study of Australian Children (LSAC) who participated in the Health CheckPoint survey and the LSAC 7th Wave. A latent class analysis (LCA) was conducted to identify clusters of children afflicted with eight diseases, such as asthma (ever diagnosed or current), wheezing, eczema, sleep problem/snoring/breathing problem, general health status, having any health condition and food allergy. Multinomial logistic regression was used to investigate the association between maternal asthma or other health conditions and LCA clusters. Results The study identified four clusters: (i) had asthma – currently healthy (11.0%), (ii) never asthmatic & healthy (64.9%), (iii) early-onset asthmatic or allergic (10.7%), and (iv) asthmatic unhealthy (13.4%). The asthmatic unhealthy cluster was in poor health in terms of health-related quality of life, general wellbeing and lung functions compared to other clusters. Children whose mothers had asthma during pregnancy were 3.31 times (OR 3.31, 95% CI: 2.06–5.30) more likely to be in the asthmatic unhealthy cluster than children whose mothers were non-asthmatic during pregnancy. Conclusion Using LCA analysis, this study improved a classification strategy for children with asthma and related morbidities to identify the most vulnerable groups within a population-based sample.

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Male sex is strongly associated with IgE-sensitization to airborne but not food allergens: results up to age 24 years from the BAMSE birth cohort

10.21203/rs.3.rs-20626/v2 ◽

2020 ◽

Author(s):

Erik Melén ◽

Anna Bergström ◽

Inger Kull ◽

Catarina Almqvist ◽

Niklas Andersson ◽

...

Keyword(s):

Birth Cohort ◽

Young Adulthood ◽

Specific Ige ◽

Population Based ◽

Food Allergens ◽

Swedish Population ◽

Ige Antibodies ◽

Clinical Investigations ◽

Male Sex ◽

Airborne Allergens

Abstract Background Up to half of the population in high-income countries has allergen-specific IgE antibodies. However, data regarding sex differences of IgE-sensitization from childhood to adulthood is limited. Objective To explore IgE-sensitization to common foods and airborne allergens in relation to sex over time in a population-based birth cohort followed up to young adulthood. Methods The Swedish population-based birth cohort BAMSE includes 4,089 subjects who have been followed regularly with questionnaires and clinical investigations. A recent 24-year follow-up included 3,069 participants (75%). Sera collected at 4, 8, 16 and 24 years were analyzed for IgE-antibodies to 14 common foods and airborne allergens. Results At 24 years sensitization to foods had decreased compared to previous follow-ups affecting 8.4%, while sensitization to airborne allergens was more common, affecting 42.2%. Male sex was associated with IgE-sensitization to airborne allergens at all ages (overall OR: 1.68, 95% CI 1.46 - 1.94) while there was no statistically significant association between sex and sensitization to food allergens (overall OR: 1.10, 95% CI 0.93 - 1.32). Levels of allergen-specific IgE did not differ significantly between males and females for any of the tested foods or airborne allergens at any age, following adjustment for multiple comparisons. Conclusion IgE-sensitization to airborne allergens increases with age up to young adulthood, whereas sensitization to food allergens seems to level off. Male sex is strongly associated with IgE-sensitization to airborne allergens from early childhood up to young adulthood. In contrast, there is little evidence for associations between sex and IgE-sensitization to foods.

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Abstract P063: Cigarette Smoking and Neuroimaging Indices of Cerebrovascular Health in a Population-based Cohort of Middle-aged Adults

Circulation ◽

10.1161/circ.133.suppl_1.p063 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

Martine Elbejjani ◽

David R Jacobs ◽

Reto Auer ◽

Nick R Bryan ◽

Lenore J Launer

Keyword(s):

Cigarette Smoking ◽

Fractional Anisotropy ◽

Population Based ◽

Smoking History ◽

Middle Aged ◽

Parietal Lobes ◽

Cerebrovascular Health ◽

Former Smokers ◽

Never Smokers ◽

Middle Aged Adults

Introduction: Several studies report an association between cigarette smoking and dementia. One proposed hypothesis is that smoking leads to adverse cognitive and brain changes through vascular pathways. To date, few data exist on the link between smoking and vascular brain measures. We examined, in a population-based middle-aged cohort, the association of history of cigarette smoking with three indicators of cerebrovascular health: (i) white matter (WM) integrity measured using WM-fractional anisotropy, (ii) abnormal WM volume, and (iii) cerebral blood flow (CBF) in the gray matter. We focused on lobar measures of these indicators to detect whether specific regional cerebrovascular indicators are differently related to smoking. Hypothesis: We assessed the hypothesis that smoking history is associated with more adverse cerebrovascular measures (lower fractional anisotropy, larger abnormal WM volumes, and lower CBF). Methods: Data come from the Coronary Artery Risk Development in Young Adults CARDIA-brain magnetic resonance imaging sub-study (n=538). Brain measures and self-reported smoking history were obtained at the 25th year follow-up (mean age=50). We used linear (for CBF and WM-fractional anisotropy) and multinomial logistic (for abnormal WM volume) regression models, adjusted for potential confounders (including vascular and lifestyle risk factors and medical conditions). Results: Compared to never-smokers, current smokers had lower WM-fractional anisotropy in all brain lobes (-0.005 lower fractional anisotropy in the occipital lobe and -0.006 in the other lobes; p<0.05). Smoking history was also associated with larger abnormal WM volumes: Compared to never-smokers, smokers and/or former-smokers had patterns of larger abnormal WM volumes in all lobes, with pronounced associations observed in the frontal lobe wherein smokers and former-smokers had up to twice the risk of having larger abnormal frontal WM volumes as never-smokers (p<0.05). Smoking history was associated with lower CBF in the occipital (-2.89 ml/100g/min (95%CI=-5.43, -0.36); p=0.03) and parietal lobes (-3.31 (95%CI=-5.91, -0.71); p=0.01). Conclusions: In this cohort of middle-aged adults, associations between smoking and adverse WM measures were observed in all brain lobes, whereas associations of smoking with CBF were localized in the occipital and parietal lobes. This localization may reflect a link between smoking and blood flow processes related to sensory-cognitive networks. In conclusion, results suggest that smoking is associated with three early-indicators of cerebrovascular burden (WM-fractional anisotropy, WM abnormal volume, and CBF) across the brain and that it may be differentially related to different regional cerebrovascular indicators.

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