Tobacco and alcohol use, fruit and vegetable consumption, physical activity habits, and participation in routine checkups and cancer screenings among adults aged 40 and older with and without chronic diseases

Vollständiger Abstract

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The study aimed to investigate tobacco and alcohol use, fruit and vegetable consumption, physical activity habits, and participation in routine checkups and cancer screenings in adults aged 40 years and older with and without a diagnosis of chronic disease. It also aimed to compare the frequentist and Bayesian statistical methods used for comparisons and to evaluate the practical significance of these associations using effect sizes. The study was cross-sectional. The data used in the study came from the Turkey Health Survey-2022 and 12,555 people were included in this study. A total of 29 variables were used, and chronic diseases was taken as a grouping variable. Both frequentist and Bayesian methods, including bivariate analyses and multivariable logistic regression models, were utilized. In the study group, 52% were female, 42.8% were overweight, and 46.8% had good general health. Overall, the findings indicate that people with chronic diseases tend to use less tobacco and alcohol, do less physical activity, and have more routine checkups and cancer screenings. Fruit and vegetable/salad consumption was similar between the groups. While frequentist and Bayesian bivariate tests yielded similar results, multivariable logistic regression highlighted critical divergences, with the Bayesian approach acting as a more conservative filter against weak predictors. Furthermore, evaluating the absolute magnitude of these associations revealed strictly small to moderate effect sizes. This study suggests that while behavioral shifts following a chronic disease diagnosis are statistically detectable, the real-world changes might be modest. Public health interventions could benefit from offering targeted programs tailored to patients’ limitations rather than generic advice. Methodologically, future health research and policy-making may benefit from placing more emphasis on effect sizes alongside frequentist or Bayesian approaches.