The Health-Related Quality-of-Life of Never Smokers, Ex-smokers, and Light, Moderate, and Heavy Smokers

doi:10.1006/pmed.1999.0523

Preventive Medicine

Volume 29, Issue 3, September 1999, Pages 139-144

https://doi.org/10.1006/pmed.1999.0523 Get rights and content

Abstract

Background. Health related quality-of-life is recog nized as an important health outcome measure; how ever, it may also have a significant application in smok ing reduction and cessation programs.

Methods. Representative population data (n = 3010) was used to compare the quality-of-life status of differ ent smoking categories with never smokers.

Results. Statistically significant differences in mean quality-of-life scores, as measured by the SF-36 health status questionnaire, were observed between never smokers, as the reference group, ex-smokers, all smok ers, and light, moderate, and heavy smokers. Heavy smokers also scored significantly lower than both other groups of smokers, scoring as low as the 29th percentile of the population on the general health di mension and lower than the 36th percentile of the pop ulation on all the mental health dimensions.

Conclusions. The design of public health smoking cessation programs should consider the varying char acteristics of different segments of the smoking popu lation. The advantages of improved quality-of-life may strengthen the argument for encouraging heavier smokers to become light smokers as a precursor to total cessation.

References (25)

D Wilson et al.
Characteristics of Heavy Smokers
Prev Med
(1992)
D Wilson et al.
Can we target smoking groups more effectively? A study of male and female heavy smokers
Prev Med
(1995)
FJ Kviz et al.
Age and smoking cessation behaviours
Prev Med
(1995)
LS Covey et al.
Depression and depressive symptoms in smoking cessation
Comp Psychol
(1990)
Ann Int Med
(1988)
AM Garratt et al.
The SF-36 health survey questionnaire: an outcome measure suitable for use within the NHS
Brit Med J
(1993)
C Lee
Perceptions of immunity to disease in adult smokers
J Behav Med
(1989)
S Chapman et al.
Self-exempting beliefs about smoking and health: differences Between smokers and ex-smokers
Am J Public Health
(1993)
R Doll et al.
Mortality in relation to smoking: 40 years' observations on male British doctors
Brit Med J
(1994)
MA Nides et al.
Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study
J Consult Clin Psychol
(1995)

S Shiffman et al.

Tobacco dependence treatments: review and prospectus

Ann Rev Public Health

(1998)

KO Fagerström et al.

Aiding reduction of smoking with nicotine replacement medications: hope for the recalcitrant smoker

Tobacco Control

(1997)

Cited by (182)

Quality of life and associations with health-related behaviours among older adults with increased cardiovascular risk
2022, Nutrition, Metabolism and Cardiovascular Diseases
Citation Excerpt :
Positive associations have also previously been reported for moderate alcohol consumption and QoL in older adults [9], including better mental health [10], despite evidence that alcohol consumption is associated with increased risk of chronic diseases, including cardiovascular disease and cancer [11]. There are divergent reports of the relationship between QoL and smoking status, with studies indicating a negative impact compared to non-smokers [12,13] and no significant association compared to ex-smokers [14]. Recent reviews on dietary intake and QoL, have found associations between adherence to dietary patterns such as Mediterranean diet and dietary approaches to stop hypertension (DASH) diet as well as diet scores such as healthy eating index (HEI), dietary quality index (DQI) with health- related QoL [15,16].
A better understanding of the relationship between cardiovascular disease risk factors and quality of life (QoL) in older age is needed to inform development of risk reduction strategies. This cross-sectional study investigated the association of QoL with health-related behaviours in older adults at risk of heart failure.
Older adults (N = 328) at risk of heart failure residing in Melbourne, Australia, provided data on QoL and health-related behaviours including physical activity, diet, smoking and alcohol consumption. Multiple linear regression modelling was used to examine associations between health-related behaviours, QoL and its constituent domains. After adjustment for age, gender, body mass index and comorbidities, current smoking was found to have a negative association with the mental component score (MCS) of QoL (β = −0.174, p ≤ 0.01), with a positive association seen between MCS and physical activity (β = 0.130, p = 0.01). Current alcohol use had a positive association with the physical component score (PCS) (β = 0.120, p = 0.02) and saturated fat intake consumption had a negative association with the physical functioning domain of QoL (β = −0.105, p = 0.03) but was not associated with either PCS or MCS.
Engagement of older adults at increased cardiovascular risk with behavioural risk factor modification using QoL as a driver of change may offer new opportunities to promote healthy ageing. Development of such strategies should consider that for some behaviours which are cardiovascular risk factors (alcohol intake, in particular), the positive association to QoL is complicated and needs further deliberation.
Health Behaviors and Health-Related Quality of Life Among U.S. Adults Aged 18–64 Years
2021, American Journal of Preventive Medicine
This study aims to (1) describe the prevalence and clustering of 3 health behaviors, (2) examine the association between individual health behaviors and health-related quality of life, and (3) explore the association between the clustering of the health behaviors and health-related quality of life.
Investigators analyzed a sample of U.S. adults aged 18–64 years using data from the 2016–2018 Behavioral Risk Factor Surveillance System survey in March 2020. Logistic regression models examined the associations among 3 healthy behaviors (currently not smoking, physical activity, and nonheavy alcohol consumption) and 4 indicators of health-related quality of life (general health, physical health, mental health, and activity limitation). Alpha was set at 0.01.
A total of 450,870 individuals were included in the analysis (weighted n=100,102,329). Of these, 82.0% were current nonsmokers, 92.8% were nonheavy drinkers, and 77.6% reported physical activity. The prevalence of having none, 1, 2, and 3 of the health behaviors was 0.7%, 7.7%, 30.1%, and 61.5%, respectively. Smoking status and physical activity status were significantly associated with all the 4 health-related quality of life indicators. Alcohol status was significantly associated with mental health and activity limitation. The associations demonstrated a higher health-related quality of life among individuals who reported healthy behaviors than among those who did not engage in healthy behaviors. Compared with respondents who reported none of the health behaviors, people with all 3 health behaviors were more likely to report higher health-related quality of life.
Health behaviors were significantly associated with health-related quality of life among U.S. adults. Healthy behaviors should be encouraged because adopting these behaviors may contribute to a higher health-related quality of life.
Individual and social predictors of smoking and obesity: A panel study in Germany
2020, SSM - Population Health
This is a longitudinal study of changes in smoking behaviour as well as becoming overweight/obese (OW/OB) and the strength of their association with personal factors such as self-control, mental health, and socioeconomic status (SES) versus their connection with the behaviour of other household members. Furthermore, we investigate that in terms of roles within a household, who is more vulnerable towards the behaviour of others. We used a hybrid model that followed individual adults (person-level fixed-effect) who participated in a national representative panel survey in Germany, SOEP, between 2008 and 2016 and answered all SF-12 items (N = 6874). The count of members in a household showing the associated adverse health behaviour was the nested random-effect. Compared with other predictors, the likelihood of a person becoming OW/OB had the strongest association with the number of cohabits who were also OW/OB and it became worse as this number increased (OR 7.18, 95% CI: 2.10–24.54 and 12.44, 95% CI: 1.53–100.85, for men and women respectively, e.g. compared with being married 2.83, 95% CI: 2.28–3.53 and 1.82, 95% CI: 1.42–2.34). However, for smoking the same rapid trend was not observed. Particularly, becoming OW/OB in female (adult) children was strongly associated with the behaviour of others (compared with household head or partner). For smoking the strongest link with others was among women who were head of the household. For both behaviours, we found neither mental health nor self-control to be strong predictors. Our findings indicate that various factors do not play equal roles in changes in health behaviour and particularly for women, becoming OW/OB is strongly connected with the behaviour of others. We further discuss the potential importance of social norms that might be helpful in developing more effective policies incorporating social connections as well as norms.
Small Airway Dysfunction Impairs Quality of Life Among Smokers With No Airflow Limitation
2020, Archivos de Bronconeumologia
La disfunción de las pequeñas vías aéreas (DPV) inducida por el tabaco contribuye precozmente a la patogenia de la limitación al flujo aéreo (LFA), aunque resulta poco conocida su repercusión en la percepción de salud. Se pretende evaluar la frecuencia de DPV en fumadores activos sin LFA y comparar la calidad de vida relacionada con la salud (CVRS) de no fumadores, fumadores sin DPV, fumadores con DPV y fumadores con LFA.
En 53 fumadores activos sin LFA, 20 fumadores con LFA y 20 no fumadores, se utilizaron los cuestionarios SF-36 y EuroQoL y se realizó oscilometría de impulsos, espirometría y determinación de las densidades de atenuación del parénquima pulmonar en inspiración y espiración máximas. Se consideró que existía DPV cuando la resistencia a 5 Hz (R5), la diferencia R5-R20 y el área de reactancia (AX) excedían su límite superior de la normalidad.
El 35,8% de los fumadores sin LFA tenía DPV. No se detectaron diferencias en los parámetros espirométricos ni la atenuación pulmonar entre los fumadores con o sin DPV y los no fumadores. Sin embargo, los fumadores con DPV presentaban una peor puntuación en los cuestionarios de CVRS que los fumadores sin DPV o los no fumadores, e intermedia a los fumadores con LFA. R5 y X5 fueron identificados como determinantes independientes de la CVRS en los fumadores sin LFA.
La DPV es frecuente en fumadores sin LFA, afectando a un tercio de los mismos, y condicionando de forma independiente su percepción de salud.
Small airway dysfunction (SAD) caused by smoking contributes to the early onset of airflow limitation (AFL), although its impact on patients’ perception of health is largely unknown. We aimed to evaluate the frequency of SAD in active smokers without AFL, and to compare health-related quality of life (HRQoL) of non-smokers, smokers without SAD, smokers with SAD, and smokers with AFL.
A total of 53 active smokers without AFL, 20 smokers with AFL, and 20 non-smokers completed the SF-36 and EuroQoL questionnaires and performed impulse oscillometry and spirometry. Pulmonary parenchymal attenuation was determined in inspiration and expiration. SAD was determined to exist when resistance at 5 Hz (R5), the difference between R5 and R20, and reactance area (AX) exceeded the upper limit of normal.
In total, 35.8% of smokers without AFL had SAD. No differences were detected in spirometric parameters or pulmonary attenuation between smokers with or without AFL and non-smokers. However, smokers with SAD had worse scores on HRQoL questionnaires than smokers without SAD or non-smokers, and scores compared to smokers with AFL were intermediate. R5 and X5 were identified as independent determinants of HRQoL in smokers without AFL.
SAD is common in smokers without AFL, affecting one third of this population, and independently affecting their perception of health.
Physician-brief advice for promoting smoking cessation among cancer patients on treatment in low and middle-income countries: a scoping review
2024, BMC Cancer
An Examination of Cigarette Smoking, Traditional Machismo, and Caballerismo Among Sexual Minority Latino Men
2024, Psychology of Men and Masculinity

View all citing articles on Scopus

¹: To whom reprint requests should be addressed. Fax: +61 (08) 8226 6291. E-mail: david.wilson;cadhs.sa.gov.au.

View full text

Regular ArticleThe Health-Related Quality-of-Life of Never Smokers, Ex-smokers, and Light, Moderate, and Heavy Smokers

Abstract

Prev Med

Prev Med

Prev Med

Comp Psychol

Ann Int Med

The SF-36 health survey questionnaire: an outcome measure suitable for use within the NHS

Brit Med J

Perceptions of immunity to disease in adult smokers

J Behav Med

Self-exempting beliefs about smoking and health: differences Between smokers and ex-smokers

Am J Public Health

Mortality in relation to smoking: 40 years' observations on male British doctors

Brit Med J

Predictors of initial smoking cessation and relapse through the first 2 years of the Lung Health Study

J Consult Clin Psychol

Tobacco dependence treatments: review and prospectus

Ann Rev Public Health

Aiding reduction of smoking with nicotine replacement medications: hope for the recalcitrant smoker

Tobacco Control

Regular Article
The Health-Related Quality-of-Life of Never Smokers, Ex-smokers, and Light, Moderate, and Heavy Smokers