University of Texas At Austin
Grant: $76,000 - National Institutes of Health - May. 7, 2009
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Award Description: Smoking research and intervention efforts have substantially neglected middle-aged and older adults, with older women who smoke particularly underserved. Yet, cigarette smoking is a significant cause of morbidity and mortality among women in midlife and aging, and the hazards of smoking for women increase with age. Although adult smoking is maintained in significant part by nicotine addiction, important aspects of women's smoking in midlife and aging may involve psychosocial factors that are amenable to intervention. Depression in particular plays a significant role in maintaining adult smoking, although much less is known about the role of depression among older smokers. The greater prevalence of depression among women makes depression an important concern in women's health in midlife and aging. Although previous research has focused on clinical depression, increasing evidence indicates that sub-clinical levels of depressive symptoms, which are prevalent among women in midlife and aging, are also linked to smoking. However, the lack of a comprehensive model of social contextual and behavioral factors that affect smoking through depression or that mediate between depression and smoking hinders interventions to reduce smoking among women in later adulthood. The Surgeon General's report on women and smoking calls for longitudinal research on depression and smoking in women across the adult lifespan. This project will examine: (1) the relationship of depressive symptoms to smoking among middle-aged and older women, (2) the predictive role of social contextual and personal factors related to depression and smoking, and (3) demographic and health-related factors that make subgroups of women especially vulnerable to depression-related smoking. In this project we will conduct secondary analyses of data from the Women's Health Initiative (WHI) Observational Study. The WHI Observational Study followed 93,676 women between the ages of 50 and 79 at enrollment for up to 8 years. The WHI Observational Study presents a unique opportunity to examine the link between depressive symptoms and smoking in a large diverse sample of postmenopausal women, with psychosocial and health-related data available at multiple time-points. Our research team will approach the study from complementary perspectives. This project is innovative in its unique focus on depression and smoking in middle-aged and older women, its use of the WHI Observational Sample to follow a socioeconomically and ethnically diverse sample longitudinally, and it's modeling of risk and protective factors in the depression-smoking relationship among women in this population. Consistent with Healthy People 2010 objectives to reduce adult smoking, this project will have a positive impact by providing a conceptual foundation for effective smoking reduction interventions with middle-aged and older women.
Project Description: We know that depression is linked to smoking. However, we know very little about the association between depressive symptoms and cigarette smoking among middle-aged and older women. Knowledge of the nature, strength, and direction of the depression-smoking relationship among middle-aged and older women can guide the choice of mental and public health services for reducing depression and smoking in this population. This phase of the project had three goals: (1) creation of working data files, (2) completion of basic analyses predicting smoking status in the full sample of 93,676 participants, and (3) completion of basic analyses predicting smoking reduction among the 5,790 current smokers at baseline. We converted the NHLBI WHI data files from SAS to SPSS files, encrypted the files on secure external drives for enhanced security, integrated the separate files from each wave of data collection into an initial longitudinal data file, and computed the primary study variables. In logistic regression analyses, history of depressive affect and current depressive symptoms at baseline were significantly associated with a higher likelihood of current smoking status at baseline. In addition, in multiple regression analyses with current smokers, history of depressive affect and current depressive symptoms at baseline were significantly associated with a higher level of smoking at baseline. Further, in logistic regression analyses, history of depressive affect and current depressive symptoms at baseline were significantly associated prospectively with a lower likelihood of an attempt to quit smoking one year later. Finally, in logistic regression analyses, history of depressive affect and current depressive symptoms at baseline were significantly associated prospectively with a lower likelihood of smoking cessation indexed across the last two study assessments. All of these effects remained significant controlling for age, minority status, and socioeconomic status.
Jobs Summary: The following were appointed to this project for a total of .53 FTE: RESEARCH PROFESSOR (0.22 FTE) ;RESEARCH ASSOC PROF (0.07 FTE); RESEARCH PROFESSOR (0.10 FTE); GRAD RESASST (0.08 FTE); and GRAD RES ASST (0.05 FTE). Calculations of Number of Jobs were made using OMB guidance. (Total jobs reported: 1)
Project Status: Less Than 50% Completed
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