The effect of smoking in midlife on health-related quality of life in old age -: A 26-year prospective study
The effect of smoking in midlife on health-related quality of life in old age -: A 26-year prospective study
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DOI：
10.1001/archinte.168.18.1968
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发表时间：
2008-10-13
影响因子：
--
通讯作者：
Miettinen, Tatu A.
中科院分区：
文献类型：
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作者：
Strandberg, Arto Y.;Strandberg, Timo E.;Miettinen, Tatu A.
背景：吸烟使人的预期寿命缩短7到10年。然而，目前尚不清楚不吸烟者寿命的延长是否会导致残疾增加，并在这些额外的最后几年降低生活质量。本研究评估中年吸烟对老年健康相关生活质量(HRQOL)的长期影响。方法：前瞻性队列研究，对参与赫尔辛基商人研究的1658名具有相似社会经济地位的白人男性(出生于1919-1934年)进行了26年的随访。所有男性在1974年基线时都是健康的，当时心血管危险因素和吸烟习惯被评估。2000年，使用邮寄的问卷对参与者进行了重新评估；使用兰德36项健康调查(类似于医疗结果研究简明健康调查)测量了HRQOL，并与基线吸烟状况有关。结果：从不吸烟的参与者(n=614)比重度吸烟者(每天吸烟20支；n=188)平均多活10年。在2000年的幸存者中(n=1131)，从不吸烟的人在所有兰德36项健康调查量表上的得分最高(即最好)。从不吸烟者和重度吸烟者之间的差异最大，从社交功能量表的4分到身体功能量表的14分不等。身体成分总分随着每日吸烟量的增加而逐渐恶化(P=.01)。结论：在这一社会经济同质性的男性队列的26年随访中，随着每日吸烟量的增加，HRQOL逐渐恶化，且呈剂量依赖性。从不吸烟的人比烟瘾大的人寿命更长，而且他们的额外寿命质量更高。
Background: Smoking shortens life expectancy by 7 to 10 years. However, it is unclear whether the enhanced longevity of nonsmokers produces increased disability and decreased quality of life during these extra final years. This study evaluates the long-term effect of smoking in midlife on health-related quality of life (HRQoL) in old age.Methods: Prospective cohort study with a 26-year follow-up of 1658 white men (born 1919-1934) of similar socioeconomic status who were participating in the Helsinki Businessmen Study. All men were healthy at baseline in 1974, when cardiovascular risk factors and smoking habits were assessed. The participants were reevaluated with the use of mailed questionnaires in 2000; HRQoL was measured with the use of the RAND 36-Item Health Survey (similar to the Medical Outcomes Study Short-Form Health Survey) and related to the baseline smoking status. Total mortality through 2000 was determined from Finnish national registers.Results: Participants who had never smoked (n = 614) lived a mean of 10 years longer than heavy smokers (>20 cigarettes daily; n = 188). Among survivors in 2000 (n = 1131), the never-smokers had the highest (ie, best) scores on all RAND 36-Item Health Survey scales. The differences were greatest between never-smokers and heavy smokers, ranging from 4 points on the scale of social functioning to 14 points on the physical functioning scale. The physical component summary score showed a graded deterioration of HRQoL with an increasing number of cigarettes smoked daily (P = .01).Conclusions: During the 26-year follow-up of this socio-economically homogeneous male cohort, HRQoL deteriorated with an increase in daily cigarettes smoked in a dose-dependent manner. Never-smokers lived longer than heavy smokers, and their extra years were of better quality.