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Religious Involvement and Cigarette Smoking in Young Adults
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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