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Could history of smoking explain the protective effect of religious attendance on mortality?

TitleCould history of smoking explain the protective effect of religious attendance on mortality?
Year of Publication2015
AuthorsBaiden, P., Fuller-Thomson E., and Howitt L.

To examine the link between religious attendance and all-cause mortality independent of well-known confounders using a nationally representative longitudinal data from Canada. Data for this study were obtained from the National Population Health Survey (NPHS). A sample of 6,635 adults who were followed from 1994/1995 to 2009 was analyzed using survival analysis. The outcome variable examined was time to death and the main independent variable was frequency of religious attendance. The study also controlled for other well-known confounders such as demographic, socioeconomic, mental health, and health behaviour factors. Results indicate that adjusting for demographic factors, respondents who attended religious services weekly in 1994 had 23% lower risk of dying during the follow-up period than those who never attend religious services (HR=0.77; 95% CI=0.66-0.89). However, the association between religious attendance and mortality was fully attenuated and became non-significant after adjusting for smoking history (HR=0.92; 95% CI=0.79-1.08). In the fully adjusted model, compared to respondents who do not smoke, the hazard ratio for respondents who currently smokes was 2.44 times greater and 1.36 times greater for those who were former smokers. Consistent with past studies, findings from this study demonstrated that those who attend religious services regularly had a lower risk of mortality independent of well-known confounders. More importantly, our findings revealed that the protective role of weekly religious attendance on mortality is largely explained by smoking behaviour. Additional study is required to understand the mechanism by which the relationship between religious attendance and mortality is mediated by smoking behaviour.

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