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

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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.

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Acknowledgments

This research was supported by grants CA87979, CA50385, and K07 CA92696-02 (Cooley) from the National Institutes of Health, and a grant from the Robert Wood Johnson Foundation #55769 (Sarna). We acknowledge Ron Hays for his consultation in issues related to the analysis and interpretation of findings of this study and Dr. Marjorie Wells, School of Nursing, University of California, for her assistance with this project.

Author information

Authors and Affiliations

  1. School of Nursing, University of California, Los Angeles, CA, USA

    Linda Sarna

  2. Tobacco Policy International, San Francisco, CA, USA

    Stella A. Bialous

  3. Dana-Farber Cancer Institute, Phyllis F. Cantor Center, Research in Nursing and Patient Care, Boston, MA, USA

    Mary E. Cooley

  4. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, and Harvard Medical School, Boston, MA, USA

    Hee-Jin Jun & Diane Feskanich

Authors
  1. Linda Sarna
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  2. Stella A. Bialous
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  3. Mary E. Cooley
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  4. Hee-Jin Jun
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Corresponding author

Correspondence to Linda Sarna.

Appendix

Appendix

Comorbid conditions: cardiovascular disease (high blood pressure, myocardial infarction, angina pectoris, peripheral artery disease or claudication, coronary artery surgery, TIA, and stroke), cancer (breast, cervical, uterine, ovarian, colon, rectum, lung, liver, melanoma, pancreas, bladder/kidney, esophageal, leukemia, laryngeal, oral, and stomach), respiratory diseases (asthma, emphysema, chronic bronchitis, and active TB), or other (diabetes mellitus, systemic lupus erythematosis, multiple sclerosis, ALS, cataracts, macular degeneration, and gastric or duodenal ulcer).

Tobacco-related diseases: cardiovascular disease (as described above), cancer (cervical, lung, pancreas, bladder/kidney, esophageal, leukemia, laryngeal, oral, and stomach), respiratory diseases (emphysema, chronic bronchitis), and macular degeneration.

Physical component scores (PCS) and mental component scores (MCS) normative scores for US females according to age [21].

Physical component score (PCS) norms by quartiles

Age (years)

Mean (SD)

<25th

25th

50th

75th

25–34

52.46 (7.66)

≤49.31

49.32

54.43

57.67

35–44

51.36 (8.34)

≤46.98

46.99

52.58

57.09

45–54

48.95 (9.64)

≤43.38

43.40

51.61

55.79

55–64

45.03 (11.57)

≤38.17

38.18

49.91

54.14

≥65

41.02 (11.52)

≤31.99

32.00

42.93

49.83

Mental component score (MCS) norms by quartiles

Age (years)

Mean (SD)

<25th

25th

50th

75th

25–34

48.34 (10.12)

≤41.89

41.90

51.31

55.22

35–44

48.84 (9.49)

≤43.22

43.23

51.16

55.75

45–54

50.07 (10.18)

≤45.54

45.55

53.48

56.99

55–64

50.56 (10.16)

≤44.60

44.61

53.71

57.94

≥65

51.44 (10.54)

≤43.42

43.43

55.08

58.96

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Sarna, L., Bialous, S.A., Cooley, M.E. et al. Impact of smoking and smoking cessation on health-related quality of life in women in the Nurses’ Health Study. Qual Life Res 17, 1217–1227 (2008). https://doi.org/10.1007/s11136-008-9404-8

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  • DOI: https://doi.org/10.1007/s11136-008-9404-8

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