Those Who Worship More Often Tend to Smoke Less

NEW YORK (Reuters Health) - Young adults who frequently attend religious services are less likely to be smokers or to start smoking at all, according to new research.

Dr. Mary A. Whooley of the University of California, San Francisco and her colleagues found that both black and white young adults who attend a religious service at least once a month are less likely to smoke cigarettes, and also less likely than non-attenders to start smoking later in life.

Although the reasons behind the association remain unknown, Whooley said she believed that religion probably doesn't make people healthy, but that religion attracts healthier people. "I think healthier people are more likely to attend religious services, and are less likely to smoke," she proposed.

During the study, the investigators surveyed 4,569 men and women aged 20 to 32 years from four US cities. Study participants indicated how often they attended religious services, to what denomination they belonged and if they smoked tobacco. The authors questioned the study participants again 3 years later to determine how many previous non-smokers had since picked up the habit.

Whooley's team found that people who said they went to a religious service less than once per month, or who never attended any services, were 70% more likely than more frequent attenders to also say they were smokers. In addition, infrequent attenders were 90% more likely than those who observed religious practices more often to say they had started smoking during the 3-year follow-up period, the authors report in the July 22nd issue of the Archives of Internal Medicine.

The association between smoking and service attendance was present for most denominations, the report indicates, but appeared strongest in certain faiths, including Baptist, Pentecostal, Seventh Day Adventist, Muslim, Mormon, Buddhist, Quaker and Hindu. Presbyterian and Jewish study participants were least likely to smoke overall.

Previous research has linked religious observances to a variety of health benefits, including reduced likelihood of heavy drinking, longer life span and reduced levels of a marker of inflammation linked to heart disease.

In an interview with Reuters Health, Whooley said this current study helps confirm previous findings about the association between healthfulness and religious observance, and shows that being healthier overall can translate into real behaviors that cut risk. "More healthy behaviors translate into real risk factor reduction--like not smoking," she said.

So why might people who practice religion also be healthier overall, as Whooley suggested? The answer, she proposed, may lie in the fact that people who practice religion believe it will provide them with better coping mechanisms, and establish them in a community, two factors that healthier people may be more likely to want for themselves.

She and her colleagues note that while some religions, such as Mormonism, specifically prohibit substance use, "most do not have explicit proscriptions against smoking."

People who belong to a religious community may develop better coping mechanisms and receive the benefits that come from being part of a community, Whooley said. "It's certainly possible that religion is contributing" to observers' more health-conscious behaviors, she noted.

The authors detected an association between service attendance and smoking in both black and white study participants, and in both genders--except among black men.

"It is possible that black men attend religious services for different reasons than do women or white men," they write. "Perhaps black men are more likely to attend services to accommodate other family members, less likely to adopt coping strategies associated with religious involvement, or less likely to derive support from the social and educational environment of a church because of more stressful life circumstances."

SOURCE: Archives of Internal Medicine 2002;162:1604-1610