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Does smoking affect health-related quality of life? Evidence to inform public health strategies

Author: Subhash Pokhrel
Institution: Brunel University
Type of case study: Research

About the research

Six million people worldwide die every year due to tobacco-related diseases. In 2006, over five per cent of the total NHS budget was spent on the direct costs of treating these diseases. If indirect costs such as lost productivity, informal care, and passive smoking for the same year are included, smoking costs an estimated £14.6 billion.

Global public health strategies aim to prevent new smokers and increase the quitting rates of current smokers. In England, smoking rates have decreased from 27 to 21 per cent, yet more must be done. This study is the first of its kind to link health-related quality of life to smoking status, with the goal of providing more specific data for targeted, cost-effective public health strategies.

The research findings suggest that the more cigarettes smoked, the worse quality of life can be expected — regardless of other factors such as lifestyle or socio-economic status. Based on the findings that smoking affects mobility, pain and discomfort, as well as, anxiety and depression at greater rates, the researchers suggest that public health officials design strategies combining several forms of interventions, such as mental health services with support to help smokers quit.

Methodology

A sample of 13,241 individuals aged 16 and older sourced from the Health Survey for England 2006 was used for the analysis.

Health-related quality of life was captured using the EQ-5D instrument, which describes health in five dimensions (mobility, self-care, usual activity, pain/discomfort, anxiety/depression). This type of measure is of growing relevance in assessing public health issues and it is one of the most qualified and common instruments used in population-based studies on health-related quality of life.

Linear or logistic regression models were fitted to control for biology, clinical conditions, socio-economic background and other lifestyle factors that an individual may have regardless of their smoking status.

In addition, age- and gender-specific predicted values according to smoking status are offered as the potential utility values to be used in future economic evaluation models.

Publications

Vogl, M., Wenig, C.M., Leidl, R. and Pokhrel, S. (2012) ‘Smoking and health-related quality of life in English general population: Implications for economic evaluation’, BMC Public Health, 12(203).  doi: 10.1186/1471-2458-12-203. Retrieved 6 March 2014 from http://www.biomedcentral.com/1471-2458/12/203