Unhealthy Coping: Smoking and Drinking Behaviors and Related Risk Factors Among Dementia Caregivers

Background: Dementia caregivers often experience high levels of stress, which may contribute to unhealthy coping behaviors such as smoking, e-cigarette use, and alcohol consumption.However, little is known about the extent of these behaviors among caregivers and whether certain subgroups are at elevated risk.Methods: This study analyzed data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) to compare tobacco smoking, e-cigarette use, and alcohol consumption between dementia caregivers (n = 511) and non-caregivers (n = 19,402).Multinomial and zero-inflated negative binomial regression models were used to examine associations between caregiving status, sociodemographic characteristics, and the unhealthy coping behaviors.Results: Dementia caregivers and non-caregivers exhibited similar overall rates of smoking, e-cigarette use, and alcohol consumption.However, significant interactions revealed that low-income (RRR = 7.03, p = 0.001) and unemployed (RRR = 4.89, p = 0.03) dementia caregivers were more likely to smoke daily, while unmarried caregivers consumed more alcohol per drinking day (IRR = 2.23, p = 0.04).Female (RRR = 1.96, p < 0.001) and Asian (RRR = 5.44, p < 0.001) dementia caregivers had significantly higher odds of daily e-cigarette use, suggesting cultural and stress-related influences on coping behaviors.Conclusions: These findings highlight the need for targeted interventions and policies to address tobacco smoking, e-cigarette use, and alcohol consumption among dementia caregivers, particularly those who are socioeconomically disadvantaged and from minority populations.