Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 44 Page 45 Page 46 Page 47 Page 48 Page 49 Page 50 Page 51 Page 52 Page 53 Page 54 Page 55 Page 56 Page 57 Page 58 Page 59 Page 60 Page 61 Page 62 Page 63 Page 64 Page 65 Page 66 Page 67 Page 68 Page 69 Page 70 Page 71 Page 72 Page 73 Page 74 Page 75 Page 76 Page 77 Page 78 Page 79 Page 80 Page 81 Page 82 Page 83 Page 84 Page 85 Page 86 Page 87 Page 88 Page 89 Page 90 Page 91 Page 92 Page 93 Page 94 Page 95 Page 96 Page 97 Page 98 Page 99 Page 100 Page 101 Page 102 Page 103 Page 104 Page 105 Page 106 Page 107 Page 108H EALTH 24 preceding the survey were as likely as those who had never smoked to report good health. Further analysis indicated that males ages 50 to 54 years who are heavy smokers lose approximately 2 years of healthy life, and females in the same age group who are heavy smokers lose about 1.5 years of healthy life, relative to former smokers. In another study of smoking cessation, Wray and colleagues (1998) analyzed data for smokers who had had heart attacks. Controlling for a variety of health factors, level of education emerged as the major positive influence on the decision by middle-aged HRS participants to quit smoking after the cardiac event. Alcohol Consumption Recent reports have suggested that moderate alcohol consumption has potentially healthful effects, but HRS data clearly show that heavy A COMMUNITY-DWELLING SAMPLE The original HRS (1992) and AHEAD (1993) samples were drawn from community-dwelling individuals and did not include people living in institutions such as nursing homes. This sampling procedure also applies to cohorts added to the study after 1993. Unless otherwise noted, data in the tables and graphs in this report refer only to community-dwelling people and do not include people who have moved into nursing homes after they were initially selected for the study. The HRS does, however, follow individuals as they move into and out of institutional settings. As the number of study participants in institutions increases, the HRS is becoming an important source of information about this segment of the U.S. population. In certain parts of this report, such as the description of living arrangements in Chapter 4, the HRS nursing home component is included. drinking takes its toll. Perreira and Sloan (2002) analyzed 6 years of HRS data to examine links be- tween excessive alcohol consumption and health outcomes for men. Men who were heavy drinkers (five or more drinks per day) but not functionally impaired in the initial survey year had a four-fold risk of developing at least one functional impair- ment (including memory problems) during the 6-year follow-up period. This finding held true even when controlling for the effects of smoking and other factors. Perreira and Sloan (2001) also used multiple waves of HRS data to explore changes in drink- ing behavior that occurred with and after major health, family, and employment stresses. Two- thirds of the sample did not change their use of alcohol in the 1990s. However, when changes did occur, they were related to several life events: Re- tirement was associated with increased drinking; Other research has examined whether the percep- tions of smokers reflect a true lack of understand- ing of health risks or a form of indifference or denial. Smith et al. (2001) investigated how sub- jective beliefs change in response to new informa- tion. This study found that when HRS smokers experience smoking-related health shocks, such as a heart attack or cancer diagnosis, they are likely to reduce their expectations of longevity significantly, more so than when they experience general (non-smoking-related) health shocks. A more traditional analysis of health outcomes addressed the effects of smoking on disability, impaired mobility, health care utilization, and self-reported health (Ostbye et al. 2002). As ex- pected, smoking was strongly related to mortality and self-reported ill health. Researchers were also able to characterize the benefits of quitting smok- ing. People who had quit smoking in the 15 years