Differences in spousal influence on smoking cessation by gender and education among Japanese couples (BMC Public Health)

Background: Previous studies have reported that spousal non-smoking has a spillover effect on the partner`s cessation. However, discussion is lacking on the factors modifying that association. We examined whether the spillover effect of spousal non-smoking was associated with the couple`s educational attainment. Methods: We used paired marital data from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE), which targeted residents aged 25-50 years in four Japanese municipalities. We selected a spouse smoker at the time of marriage (target respondent), and set his/her smoking status change (continued or quit smoking after marriage) as an outcome, regressed on the counterpart`s smoking status (continued smoking or non-smoking) and combinations of each couple`s educational attainment as explanatory variables using log-binomial regression models (n =1001 targets; 708 men and 293 women). Results: Regression results showed that a counterpart who previously quit smoking or was a never-smoker was associated with the target male spouse`s subsequent cessation. However, for women, the association between husband`s non-smoking and their own cessation was significant only for couples in which both spouses were highly educated. Conclusions: Our findings suggest that a spouse`s smoking status is important for smoking cessation interventions in men. For women, however, a couple`s combined educational attainment may matter in the interventions.