Impact of smoking and smoking cessation on health-related quality of life in women in the Nurses’ Health Study

Abstract

Purpose To examine the relationship between smoking and health-related quality of life (HRQOL) and the impact of quitting smoking on changes in HRQOL among women in the two Nurses’ Health Study (NHS) cohorts (n = 158,736) who were 29 to 71 years of age in 1992/1993 when they reported data on smoking status and completed the Short Form-36® version 1 (SF-36®). Methods At baseline, the SF-36® physical component scores (SF-PCS) and mental component scores (SF-MCS) were examined by smoking status (never, 56%, former, 32%, and current, 13%) within 10-year age groups. Smoking characteristics were analyzed as correlates of SF-36®. Changes in smoking status and SF-PCS and SF-MCS, adjusted for comorbid disease and other covariates, were reassessed at 4-year intervals among current smokers in 1992/1993 and those who either continued smoking after 4 and 8 years or reported not smoking at both intervals. Results Smokers had lower HRQOL (SF-PCS and SF-MCS) as compared to never and former smokers. Current smoking, cigarettes per day and time since quitting were associated with significantly lower SF-PCS and SF-MCS. Continuing smokers and those who quit had significant declines in SF-PCS over time and significant improvements in SF-MCS at 8 years. There was minimal difference between groups, with some greater improvements in SF-MCS among those reporting non-smoking at 8 years. These findings support the lower ratings of HRQOL by smokers, but quitting alone, after an average of 21 years of smoking, did not improve HRQOL. Further study focused on the HRQOL impact of quitting smoking is needed.

Factors associated with cessation of smoking among Swiss adults between 1991 and 2011: results from the SAPALDIA cohort

“…Our data on the health-related quality of life assessed with the SF-36 questionnaire showed that current smokers with a lower vitality score had a higher probability of quitting, whereas those with a lower social functioning score were less likely to quit. This is consistent with the results of previous studies, where persons who continued smoking had lower social functioning scores than those who quitted smoking [40,41]. Moreover, a higher number of cigarettes smoked per day has been significantly associated with a lower vitality score [40,42], possibly reflecting impaired physical health.…”

“…This is consistent with the results of previous studies, where persons who continued smoking had lower social functioning scores than those who quitted smoking [40,41]. Moreover, a higher number of cigarettes smoked per day has been significantly associated with a lower vitality score [40,42], possibly reflecting impaired physical health. However, in our study the association was observed after adjusting for chronic diseases and even in a sensitivity analysis where we excluded the participants with chronic diseases (data not shown).…”

Preditores da qualidade de vida em fumadores e abstinentes

“…Foram ainda corroborados os dados da investigação indicativos de que abstinentes com doença respiratória crónica apresentam pior qualidade de vida, níveis mais elevados de morbilidade psicológica (Chapman, Perry & Strine, 2005) e mais estratégias de coping passivas que os abstinentes sem doença respiratória crónica. Abstinentes com longa história de consumo de tabaco tendem a apresentar uma saúde física e emocional debilitada, podendo percecpionar apenas ténues melhorias na sua qualidade de vida física (Sarna et al, 2008). Assim, as suas expectativas de melhoria na qualidade de vida ficam reduzidas, levando-os a optar por estratégias de coping de evitamento (Friedman-Wheeler, Haaga, Gunthert, Ahrens & McIntosh, 2008).…”

“…O principal benefício da desabituação tabágica consiste na redução da morbilidade do indivíduo, melhorando assim a sua qualidade de vida (Sarna, Bialous, Cooley, Jun, & Feskanich, 2008). Em contexto de saúde e doença, a qualidade de vida engloba uma análise subjetiva do bem-estar físico, mental e social que pode variar no tempo (WHO, 2002).…”

“…Em contexto de saúde e doença, a qualidade de vida engloba uma análise subjetiva do bem-estar físico, mental e social que pode variar no tempo (WHO, 2002). A longa duração de consumo de tabaco e o número elevado de cigarros fumados por dia associam-se à reduzida qualidade de vida (Efstratiadis, Kennard, Kelsey, & Michaels, 2008;Sarna et al, 2008) e quanto maior a dependência, mais forte tende a ser esta relação (Schmitz, Kruse, & Kugler, 2003). Após 10 anos de consumo, surgem sintomas subtis e, após 20 a 30 anos, são visíveis problemas físicos graves (Machain et al, 2008).…”