Association between smoking and health outcomes in an economically deprived population: the Liverpool Lung Project

Sherratt, Frances C; Field, John K.; Marcus, Michael W.

doi:10.1136/jech-2016-208730

Cited by 8 publications

(8 citation statements)

References 29 publications

(23 reference statements)

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“…The findings from this analysis are aligned with the limited available literature. Specifically, we found that patients with cancer who were smokers were younger and more commonly males compared with patients with cancer who were not smokers, which is in line with the literature 10 32. Additionally, smokers had, on average, almost 20% higher total monthly healthcare costs than non-smokers.…”

Section: Discussionsupporting

confidence: 89%

Impact of smoking on health system costs among cancer patients in a retrospective cohort study in Ontario, Canada

et al. 2019

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ObjectiveSmoking is the main modifiable cancer risk factor. The objective of this study was to examine the impact of smoking on health system costs among newly diagnosed adult patients with cancer. Specifically, costs of patients with cancer who were current smokers were compared with those of non-smokers from a publicly funded health system perspective.MethodsThis population-based cohort study of patients with cancer used administrative databases to identify smokers and non-smokers (1 April 2014–31 March 2016) and their healthcare costs in the 12–24 months following a cancer diagnosis. The health services included were hospitalisations, emergency room visits, drugs, home care services and physician services (from the time of diagnosis onwards). The difference in cost (ie, incremental cost) between patients with cancer who were smokers and those who were non-smokers was estimated using a generalised linear model (with log link and gamma distribution), and adjusted for age, sex, neighbourhood income, rurality, cancer site, cancer stage, geographical region and comorbidities.ResultsThis study identified 3606 smokers and 14 911 non-smokers. Smokers were significantly younger (61 vs 65 years), more likely to be male (53%), lived in poorer neighbourhoods, had more advanced cancer stage,and were more likely to die within 1 year of diagnosis, compared with non-smokers. The regression model revealed that, on average, smokers had significantly higher monthly healthcare costs ($5091) than non-smokers ($4847), p<0.05.ConclusionsSmoking status has a significant impact on healthcare costs among patients with cancer. On average, smokers incurred higher healthcare costs than non-smokers. These findings provide a further rationale for efforts to introduce evidence-based smoking cessation programmes as a standard of care for patients with cancer as they have the potential not only to improve patients’ outcomes but also to reduce the economic burden of smoking on the healthcare system.

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Section: Discussionsupporting

confidence: 89%

Impact of smoking on health system costs among cancer patients in a retrospective cohort study in Ontario, Canada

et al. 2019

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“…Smoking and excessive alcohol consumption lead to increased health risks, these lifestyle habits must therefore become targets for interventions to reduce the global CAP burden. 35 36 In addition, more effective strategies are needed to improve vaccination coverage since less than one-third of the population at risk in our study had received influenza and/or pneumococcal vaccines even though these are recommended by local scientific societies. Both vaccines are available free of charge in General Roca, and influenza vaccine is available free in Rivera.…”

Section: Discussionmentioning

confidence: 96%

Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America

Lopardo

Fridman

Raimondo³

et al. 2018

BMJ Open

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ObjectiveTo determine the incidence rate and mortality of community-acquired pneumonia (CAP) in adults in three cities in Latin America during a 3-year period.DesignProspective population-based surveillance study.SettingHealthcare facilities (outpatient centres and hospitals) in the cities of General Roca (Argentina), Rivera (Uruguay) and Concepción (Paraguay).Participants2302 adults aged 18 years and older with CAP were prospectively enrolled between January 2012 and March 2015.Main outcome measuresIncidence rates of CAP in adults, predisposing conditions for disease, mortality at 14 days and at 1 year were estimated. Incidence rate of CAP, within each age group, was calculated by dividing the number of cases by the person-years of disease-free exposure time based on the last census; incidence rates were expressed per 1000 person-years.ResultsMedian age of participants was 66 years, 46.44% were men, 68% were hospitalised. Annual incidence rate was 7.03 (95% CI 6.64 to 7.44) per 1000 person-years in General Roca, 6.33 (95% CI 5.92 to 6.78) per 1000 person-years in Rivera and 1.76 (95% CI 1.55 to 2.00) per 1000 person-years in Concepción. Incidence rates were highest in participants aged over 65 years. 82.4% had at least one predisposing condition and 48% had two or more (multimorbidity). Chronic heart disease (43.6%) and smoking (37.3%) were the most common risk factors. 14-day mortality rate was 12.1% and 1-year mortality was 24.9%. Multimorbidity was associated with an increased risk of death at 14 days (OR 2.91; 95% CI 2.23 to 3.80) and at 1 year (OR 3.00; 95% CI 2.44 to 3.70).ConclusionsWe found a high incidence rate of CAP in adults, ranging from 1.76 to 7.03 per 1000 person-years, in three cities in South America, disclosing the high burden of disease in the region. Efforts to improve prevention strategies are needed.

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“…Health behaviors are important to understanding population health disparities as they are empirically linked to multiple health outcomes and can ultimately lead to increased health care costs and premature death. For example, smoking is associated with a number adverse health outcomes including acute myeloid leukemia and cancers of the stomach, liver, bladder, cervix, pancreas, kidney, and esophagus ( Helms et al, 2017 , Sherratt et al, 2017 , HHS, 2014 ). Stroke, cataracts, coronary heart disease, chronic obstructive pulmonary disease, pneumonia, emphysema, bronchitis, lung cancer, diabetes, cardiovascular disease, immune function issues, and overall diminished health are also more common among smokers (HHS, 2014, Sherratt et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…For example, smoking is associated with a number adverse health outcomes including acute myeloid leukemia and cancers of the stomach, liver, bladder, cervix, pancreas, kidney, and esophagus ( Helms et al, 2017 , Sherratt et al, 2017 , HHS, 2014 ). Stroke, cataracts, coronary heart disease, chronic obstructive pulmonary disease, pneumonia, emphysema, bronchitis, lung cancer, diabetes, cardiovascular disease, immune function issues, and overall diminished health are also more common among smokers (HHS, 2014, Sherratt et al 2017 ). Physical inactivity is associated with chronic diseases such as cardiovascular disease, diabetes, asthma, arthritis, cancer, and hypertension as well as premature death ( Warburton et al, 2006 , Humphreys et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Disparities in individual health behaviors between medicaid expanding and non-expanding states in the U.S.

Rhubart

2018

SSM - Population Health

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Following the roll out of the Affordable Care Act, a significant amount of research has focused on health insurance coverage disadvantages experienced by those in states that chose not to expand Medicaid. This line of research has been used as a way to conceptualize potential disparities in future population health outcomes between states that did and did not expand Medicaid. While health insurance is certainly associated with health outcomes, health behaviors are equally, if not more, important. Therefore, to understand potential future population health outcomes - or lack thereof – this paper examines whether adults in states that did not expand Medicaid are also more likely to engage in health damaging behaviors (i.e. smoking, heavy drinking, physical inactivity, and overweight and obesity) than adults in states that expanded Medicaid. I find that those in states that did not expand Medicaid are more likely to be overweight and obese but are less likely to drink heavily compared to adults in states that did expand Medicaid. In part, higher rates of demographic and socioeconomic disadvantage explain higher rates of health damaging behaviors in states that did not expand Medicaid. This paper raises concerns about added long term consequences for population health and growing health disparities between states that did and did not expand Medicaid. Policy and practice implications of these findings are discussed.

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Association between smoking and health outcomes in an economically deprived population: the Liverpool Lung Project

Cited by 8 publications

References 29 publications

Impact of smoking on health system costs among cancer patients in a retrospective cohort study in Ontario, Canada

Impact of smoking on health system costs among cancer patients in a retrospective cohort study in Ontario, Canada

Incidence rate of community-acquired pneumonia in adults: a population-based prospective active surveillance study in three cities in South America

Disparities in individual health behaviors between medicaid expanding and non-expanding states in the U.S.

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