Smoking and Health-Related Quality of Life (SF-36). A Population-Based Study in Campinas, SP, Brazil

Margareth Guimarães Lima, Flávia Silva Arbex Borim, Marilisa Berti de Azevedo Barros

Faculty of Medical Sciences, Department of Public Health, State University of Campinas, Campinas, Brazil.

DOI: 10.4236/health.2014.612189                

Abstract

Introduction: Smoking persists as a global and relevant health problem being one of the major risk factors to non-communicable diseases and early death. Studies on the association between smoking and health related quality of life (HRQL) are scarce in Brazil and Latin America. The aim of this study was to analyze the HRQL according to smoking status on adults aged 20 to 59 years, living in Campinas, Brazil. Method: It is a population-based cross-sectional study, carried out with data from the Campinas Health Survey developed in 2008/2009. The dependent variables were the eight scales and the two components—physical (PCS) and mental component summary (MCS) of the instrument SF-36, version 2. Means and confidence intervals of the SF-36 scale scores and components were estimated according to smoking (never smokers, former smokers, current smokers) and nicotine dependence (mild, moderate, heavy). Results: The sample comprised 957 individuals (mean age of 37.5 years). Comparing with never smokers, smokers had lower score means in all SF-36 scales, except in physical functioning and role-physical; among the former smokers, lower scores were observed in vitality and mental health. A reduction of the MCS score was observed among smokers and former smokers among men; but in the female population, this reduction was observed only in smokers compared with never smokers. According to the nicotine dependence, it was observed an increasing reduction in MCS scores from mild, to moderate and heavy smokers. Conclusion: Smoking is significantly and negatively associated with HRQL in the studied population. The results point out the importance of the strategic policies against smoking, to reduce morbidity and premature death, but also to increase the quality of life and well-being. It is also important to consider the mental health dimension, since that best mental health can be relevant to promote healthier behaviors.

Keywords

Smoking, Quality of Life, Health Status, SF-36, Survey

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	WHO (World Health Organization) (2009) Global Health Risks: Mortality and Burden of Disease Attributable to selected Major Risks. WHO, Geneva.
[2]	WHO (World Health Organization) (2010) Global Status Report on Non Communicable Diseases, 2010. WHO, Geneva.
[3]	WHO (World Health Organization) (2011) WHO Report on the Global Tobacco Epidemic, 2011: Warning about the Dangers of Tobacco. WHO, Geneva.
[4]	Brasil. Ministério da Saúde. Secretaria de Vigilancia em Saúde. Departamento de Análise de Situação de Saúde (2011) Plano de ações estratégicas para o enfrentamento das doenças crônicas não transmissíveis (DCNT) no Brasil 2011-2022/ Ministério da Saúde. Secretaria de Vigilancia em Saúde. Departamento de Análise de Situação de Saúde. Ministério da Saúde, Brasília.
[5]	Brasil. Ministério da Saúde. Secretaria de Vigilancia em Saúde. Secretaria de Gestão Estratégica e Participativa (2011) VIGITEL Brasil 2010: Vigilancia de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Ministério da Saúde, Brasília.
[6]	Silva, G.A., Valente, J.G. and Malta, D.C. (2011) Trends in Smoking among the Adult Population in Brazilian Capitals: A Data Analysis of Telephone Surveys from 2006 to 2009. Revista Brasileira de Epidemiologia, 14, 103-114. http://dx.doi.org/10.1590/S1415-790X2011000500011
[7]	Ware Jr., J.E., Kosinski, M., Bjorner, J.B., Turner-Bowker, D.M., Gandek, B. and Maruish, M.E. (2007) User’s Manual for the 36v2® Health Survey. 2nd Edition, Quality Metric Incorporated, Lincoln.
[8]	Almeida-Filho, N. (2011) O que é Saúde? Editora Fiocruz, Rio de Janeiro.
[9]	Lima, M.G., Barros, M.B.A. and Alves, M.C.G.P. (2012) Happiness in the Elderly: An Edipemiological Aproach in the ISA-Camp 2008 Study. Cadernos de Saúde Pública, 28, 2280-2292.
[10]	Ciconelli, R.M., Ferraz, M.B., Santos, W., Meinão, I. and Quaresma, M.R. (1999) Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Revista Brasileira de Reumatologia, 39, 143-150.
[11]	McDowell, I. (2006) Measuring Health: A Guide to Rating Scales and Questionnaires. 3nd Edition, Oxford University Press, Inc., New York. http://dx.doi.org/10.1093/acprof:oso/9780195165678.001.0001
[12]	Fryback, D.G. (2010) Measuring Health-Related Quality of Life. Workshop on Advancing Social SCIENCE Theory: The Importance of Common Metrics. The National Academies, Division of Behavioral and Sciences and Education. Washington DC.
[13]	Lyons, R.A., Lo, S.V. and Littlepage, B.N.C. (1994) Perception of Health amongst Ever-Smokers and Never-Smokers: A Comparison Using the SF-36 Health Survey Questionnaire. Tobacco Control, 3, 213-215. http://dx.doi.org/10.1136/tc.3.3.213
[14]	Woolf, S.H., Rothemich, S.F., Johnson, R.E. and Marsland, D.W. (1999) Is Cigarette Smoking Associated with Impaired Physical and Mental Functional Status? A Office-Based Survey of Primary Care Patients. American Journal of Preventive Medicine, 17, 134-137. http://dx.doi.org/10.1016/S0749-3797(99)00060-4
[15]	Mulder, I., Tijhuis, M., Smit, H.á. and Kromhout, D. (2001) Smoking Cessation and Quality of Life: The Effect of Amount of Smoking and Time since Quitting. Preventive Medicine, 33, 653-660. http://dx.doi.org/10.1006/pmed.2001.0941
[16]	Sarna, L., Bialous, S.A., Cooley, M.E., Jun, H. and Feskanich, D. (2008) Impact of Smoking and Smoking Cessation on Health-Related Quality of Life in Women in the Nurses’ Health Study. Quality of Life Research, 17, 1217-1227. http://dx.doi.org/10.1007/s11136-008-9404-8
[17]	Lima, M.G., Barros, M.B.A., César, C.L.G., Carandina, L., Goldbaum, M. and Alves, M.C.G.P. (2011) Health-Related Behavior and Quality of Life among the Elderly: A Population-Based Study. Revista de Saúde Pública, 45, 845-893. http://dx.doi.org/10.1590/S0034-89102011000300006
[18]	Mitra, M., Chung, M., Wilber, N. and Walker, D.K. (2004) Smoking Status and Quality of Life. A Longitudinal Study among Adults with Disabilities. American Journal of Preventive Medicine, 27, 258-260.
[19]	Guitérrez-Bedmar, M., Seguí-Gómez, M., Gómez-Gracia, E., Bes-Ratrollo, M. and Martínez-González, M.A. (2009) Smoking Status, Changes in Smoking Status and Health-Related Quality of Life: Findings from the SUN (“Seguimien-to Universidad de Navarra”) Cohort. International Journal of Environmental Research and Public Health, 6, 310-320. http://dx.doi.org/10.3390/ijerph6010310
[20]	Gulliford, M.C., Sedgwick, J.E.C. and Pearce, A.J. (2003) Cigarette Smoking, Health Status, Socio-Economic Status and Access to Health Care in Diabetes Mellitus: A Cross-Sectional Survey. BMC Health Services Research, 3, 4. http://dx.doi.org/10.1186/1472-6963-3-4
[21]	Laaksonen, M., Rahkonen, O., Martikainen, P., Karvonen, S. and Lahelma, E. (2006) Smoking and SF-36 Health Functioning. Preventive Medicine, 42, 206-209. http://dx.doi.org/10.1016/j.ypmed.2005.12.003
[22]	Heikkinen, H., Jallinoja, P., Saarni, S.I. and Patja, K. (2008) The Impact of Smoking on Health-Related and Overall Quality of Life: A General Population Survey in Finland. Nicotine & Tobacco Research, 10, 1199-1107. http://dx.doi.org/10.1080/14622200802163142
[23]	Wilson, D., Parsons, J. and Wakefield, M. (1999) The Health-Related Quality-of-Life of Never Smokers, Ex-Smokers, and Light, Moderate, and Heavy Smokers. Preventive Medicine, 29, 139-144. http://dx.doi.org/10.1006/pmed.1999.0523
[24]	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 Evaluations. BMC Public Health, 12, 203. http://dx.doi.org/10.1186/1471-2458-12-203
[25]	Ware, J.E. and Kosinski, M. (2001) SF-36 Physical & Mental Health Summary Scales: A Manual for Users of Version 1, 2nd Edition. Quality Metric Incorporated, Lincoln.
[26]	Meneses-Gaya, I.C., Zuardi, A.W., Loureiro, S.R. and Crippa, J.A.S. (2009) As propriedades psicométricas do teste de Fagerstrom para dependência de nicotina. Jornal Brasileiro de Pneumologia, 35, 73-82. http://dx.doi.org/10.1590/S1806-37132009000100011
[27]	Cayuela, A., Rodríguez-Domínguez, S. and Otero, R. (2007) Deteriorated Health-Related Quality of Life in Healthy Male Smokers. Archivos de Bronconeumología, 43, 59-63.
[28]	Díez, J.M., Maestu, L.P., Peña, M.M.E., Barrera, V.H., Garrido, P.C., Walther, L.A.A. and García, R.J. (2010) Relationship between Tobacco Consumption and Health-Related Quality of Life in Adults Living in a Large Metropolitan Area. Lung, 188, 393-399. http://dx.doi.org/10.1007/s00408-010-9256-1
[29]	Hays, R.D., Smith, A.W., Reeve, B.B., Spritzer, S.E.M. and Clauser, S.B. (2008) Cigarette Smoking and Health-Related Quality of Life Medical Beneficiaries. Health Care Financing Review, 29, 57-67.
[30]	Tillmann, M. and Silcock, J. (1997) A Comparison of Smoker’s and Ex-Smoker’s Health-Related Quality of Life. Journal of Public Health Medicine, 19, 268-273. http://dx.doi.org/10.1093/oxfordjournals.pubmed.a024629
[31]	Piper, M.E., Kenford, S., Fiore, M.C. and Baker, T.B. (2012) Smoking Cessation and Quality of Life: Changes in Life Satisfaction over 3 Years Following a Quit Attempt. Annals of Behavioral Medicine, 43, 262-270. http://dx.doi.org/10.1007/s12160-011-9329-2
[32]	Kubzansk, L.D., Sparrow, D., Vokonas, P. and Kawachi, I. (2001) Is the Glass Half Empty or Half Full? A Prospective Study of Optimism and Coronary Heart Disease in the Normative Aging Study. Psychosomatic Medicine, 63, 910-916. http://dx.doi.org/10.1097/00006842-200111000-00009
[33]	Kubzansk, L.D. and Thuston, R.C. (2007) Emotional Vitality and Incident Coronary Heart Disease. Archives of General Psychiatry, 64, 1393-401. http://dx.doi.org/10.1001/archpsyc.64.12.1393
[34]	Collins, A.L., Goldman, N. and Rodriguez, G. (2008) Is Positive Well-Being Protective of Mobility Limitations among older Adults? Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 63, 321-327.
[35]	Baruth, M., Lee, D.C., Sui, X., Church, T.S., Marcus, B.H., Wicox, S. and Blair, S.N. (2011) Emotional Outlook on Life Predicts Increases in Physical Activity among Initially Inactive Men. Health Education & Behavior, 38, 150-158. http://dx.doi.org/10.1177/1090198110376352
[36]	Ware, J.E. and Kosinsk, M. (2000) SF-36 Health Survey: Manual and Interpretation Guide. 2a. Edição. Quality Metric Incorporated, Lincoln.