Health-related quality of life and health risk behaviors among smokers

Background It is well established that smoking has detrimental effects on physical health, but its associations with health-related quality of life (HRQOL) and a variety of health behaviors have not been widely investigated in the U.S. population. Methods Data obtained from the Behavioral Risk Factor Surveillance System (BRFSS), an ongoing, state-based, random-digit-dialed telephone survey of non-institutionalized persons aged ≥18 years in the United States, Guam, Puerto Rico, and the Virgin Islands, were used in this investigation. The BRFSS monitors the prevalence of key health- and safety-related behaviors and characteristics. In 2001 and 2002 combined, trained interviewers administered HRQOL questions in 23 states and the District of Columbia (n=82,918). This analysis was conducted in 2004. Results Overall, an estimated 22.4% of adults were current smokers, 24.1% were former smokers, and 53.6% never smoked. Current smokers had significantly poorer HRQOL than those who had never smoked, and were more likely to drink heavily, to binge drink, and to report depressive and anxiety symptoms. Additionally, current smokers were significantly more likely than those who never smoked to be physically inactive, to report frequent sleep impairment, to report frequent pain, and to eat less than five servings of fruits and vegetables per day. Conclusions While there are strong positive relationships between smoking and both alcohol consumption and mood disturbance, smoking is also associated with an array of other modifiable risk factors meriting assessment and intervention. In addition to smoking cessation, the increased morbidity and mortality characterizing smokers may potentially be further reduced by improvements in diet, physical activity, and sleep.