Smoking and Deaf Adults: Associations with Age at Onset of Deafness

By Barnett, Steven; Franks, Peter | American Annals of the Deaf, March 1999 | Go to article overview

Smoking and Deaf Adults: Associations with Age at Onset of Deafness


Barnett, Steven, Franks, Peter, American Annals of the Deaf


moking is a major health problem whose prevalence in different populations is thought to be influenced by sociocultural and linguistic factors. Although smoking and hearing loss are positively correlated, little is known about the smoking habits of deaf populations. Using national survey data, this study determined the smoking prevalence in two socioculturally distinct deaf populations, based on age at onset of deafness. The smoking prevalence in each deaf population was compared to the smoking prevalence in the hearing population in multivariate analyses that adjusted for sociodemographics and health status. The smoking prevalence among postlingually deafened adults was not significantly different from that among hearing adults. Prelingually deafened adults were found to be less likely to smoke than hearing adults, even though they have less education and lower income, factors both associated with higher smoking prevalence in other populations. The lower smoking prevalence among prelingually deafened adults may be due to cultural differences or to limited access to English-language tobacco advertising.

Racial and ethnic differences in smoking prevalence are known to exist (Centers for Disease Control and Prevention [CDC], 1997a, 1997b, 1998a, 1998b; Winkleby, Kraemer, Ahn, & Varady, 1998), and these differences are thought to be influenced by sociocultural and linguistic factors (CDC, 1997a, 1997b). In the United States, the 4.8 million people who cannot hear and understand normal speech (Ries, 1994) comprise several socioculturally and linguistically distinct Deaf communities (Benderly, 1980; Phillips, 1996). Despite the size of this population and the health significance of smoking, little is known about the smoking habits of deaf populations.

Although a positive correlation has been found between hearing loss and smoking (Cruickshanks et al., 1998), there are few studies on smoking and deaf people, and these studies are limited and have inconsistent results. One study indicated that smoking prevalence among deaf people is similar to that among the general population (MacKinney, Walters, Bird, & Nattinger, 1995). Another study found that smoking was less prevalent among deaf people than among the general population (Zazove et al., 1993). Zazove et al. also reported that among deaf people who smoke, those preferring American Sign Language (ASL) over oral communication smoked more. These studies have sample size and geographic limitations.

The relative lack of data and the inconsistencies of previous findings make it difficult to identify and understand the health care needs of deaf people. Although typically studied as a single homogeneous population, people with hearing loss form distinctive subpopulations based on sociocultural characteristics (Benderly, 1980; Phillips, 1996). Age at onset of a severe bilateral hearing loss can have a significant effect on communication and socialization. People deafened after early adulthood and the completion of their basic education are more likely to communicate well in English. People deafened prelingually are more likely to communicate using a sign language. These different communication modes have significant social implications for their users, and these sociocultural factors should influence smoking habits. In the present study, we examined smoking prevalence and its relationship with age at onset of deafness.

Methods

Data Source

The National Health Interview Survey (NHIS) collects data on the civilian noninstitutionalized population of the United States. By means of home interviews, these data are obtained in a continuing nationwide sample of households. The sampling follows a multistage probability design and includes oversampling of minority populations. Members of the armed forces, U.S. nationals living abroad, homeless people, and institutionalized people, including nursing home residents, are excluded from the data collection. …

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