Lauri Sillanmäki

Introduction: Breast cancer (BC) and its treatment is associated with several physical and psychosocial changes that may influence sexuality for years after treatment. Women with BC show significantly greater rates of sexual dysfunction than do healthy women. The purpose of the study was to evaluate how a BC diagnosis associates with women’s perceived sexuality and sexual satisfaction. Material and methods: The data of the ongoing prospective Health and Social Support (HeSSup) survey was linked with national health registries. Respondents with registry data confirmed BC (n = 66), mental depression (n = 612), arterial hypertension (n = 873), and healthy women (n = 9731) formed the study population. The importance of and satisfaction with sex life were measured by a self-report questionnaire modified from the Schover’s and colleagues’ Sexual History Form. Results: Women with BC considered sex life less important than did healthy women (p < 0.001). They were significantly less satisfied with their sex life than healthy women (p = 0.01) and women with arterial hypertension (p = 0.04). Living single or educational level did not explain the differences between the groups. Conclusions: BC survivors depreciate their sex life and experience dissatisfaction with it. Sexuality can be a critical issue for the quality of life of women surviving from BC, and hence, the area deserves major attention in BC survivorship care. Health care professionals should regularly include sexual functions in the assessment of BC survivors’ wellbeing.

Aims: Smoking initiation during childhood or adolescence is strongly associated with friends’ smoking. Likewise, adverse living conditions increase the likelihood of future deviant behaviour. We examine whether smoking by a best friend and family members during school years as well as adverse childhood experiences are associated with smoking in adulthood. Data and Design: We have analysed the responses of Finnish working-aged respondents in 1998 (N=25901) and 2003 (N=20773) to questions on the smoking status of friends and family members during school years as well as their answers on a six-item scale of childhood adversities. A case-control study design was used to compare current cigarette smokers (1998 and 2003) to non-smokers (1998 and 2003). Results: If a best friend during school years was a smoker, the subject s odds ratio (OR) of being a smoker in adulthood was 4.43 among females and 3.91 among males compared to those with a non-smoking best friend in multivariate models adjusted for smoking by family members during school years and by six childhood adversities. These associations did not differ by age. Smoking in adulthood was associated with childhood adversities, most strongly with parental divorce or separation during the subjects’ school years. Conclusion: Smoking by a best friend and parental divorce or separation during school years appears to be a strong factor of smoking in later life.