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The CARDIA Study

Mary A. Whooley, MD; Alisa L. Boyd, MPH; Julius M. Gardin, MD; David R. Williams, PhD, MPH

Arch Intern Med. 2002;162:1604-1610.

Background  Results of previous studies have suggested that involvement in religious activities may be associated with lower rates of smoking. We sought to determine whether frequent attendance at religious services is associated with less smoking among young adults.

Methods  This prospective cohort study of 4569 adults aged 20 to 32 years included approximately equal numbers of blacks and whites and men and women from 4 cities in the United States who attended the 1987/1988 examination of the Coronary Artery Risk Development in Young Adults (CARDIA) study. Frequency of attendance at religious services and denominational affiliation were determined by self-report questionnaire in 1987/1988. Cigarette smoking was determined by interview at this time and again 3 years later.

Results  Of 4544 participants who completed the tobacco questionnaire in 1987/1988, 34% (891/2598) who attended religious services less than once per month or never and 23% (451/1946) who attended religious services at least once per month reported current smoking (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.5-2.0; P<.001). This association between less frequent attendance at religious services and current smoking was found in most denominations and remained significant after adjusting for potential confounding variables (OR, 1.5; 95% CI, 1.3-1.8; P<.001). During 3-year follow-up, nonsmokers who reported little or no religious involvement had an increased risk of smoking initiation (adjusted OR, 1.9; 95% CI, 1.3-2.7; P<.001).

Conclusions  Young adults who attend religious services have lower rates of current and subsequent cigarette smoking. The potential health benefits associated with religious involvement deserve further study.

From the Department of Veterans Affairs Medical Center, San Francisco, Calif (Dr Whooley and Ms Boyd); the Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco (Dr Whooley); the Division of Cardiology, St John Hospital and Medical Center, Detroit, Mich (Dr Gardin); and the Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor (Dr Williams).

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