Annals of Behavioral Medicine

, Volume 17, Issue 4, pp 331–338

Does smoking cessation improve health-related quality-of-life?

  • Anita L. Stewart
  • Abby C. King
  • Joel D. Killen
  • Philip L. Ritter
Empirical Research

Abstract

This article examines whether smokers who enrolled in a community-based smoking cessation program and were successful in quitting for a six-month period had better health-related quality-of-life at six months relative to those who relapsed. An observational, longitudinal design was used; the sample included 350 participants 18–65 years of age. Health-related quality-of-life was measured using a broad array of indicators of physical and mental health. Six-month outcomes were compared between successful quitters and relapsers using analysis of covariance. Those who quit for six months had better psychological well-being, cognitivefunctioning, energy/fatigue, sleep adequacy, selfesteem, sense of mastery, and worse role functioning at six months than those who continued to smoke (p values > .05). No differences were observed in physical and social functioning, pain, or current health perceptions. There were no significant differences at enrollment in health-relatedquality-of-life between those who quit subsequently and those who relapsed, thus quality-of-life measures did not predict smoking status. We conclude that smokers who quit can possibly anticipate improvements in a range of mental health outcomes within six months, which could become an additional incentive to quit. Subsequent smoking cessation studies should include health-related quality-of-life measures to determine the generalizability of these findings.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. (1).
    Novello AC: Surgeon General’s report on the health benefits of smoking cessation.Public Health Reports. 1990,105:545–548.PubMedGoogle Scholar
  2. (2).
    Kaplan RM: Behavior as the central outcome in health care.American Psychologist. 1990, {iit45}:1211–1220.CrossRefGoogle Scholar
  3. (3).
    Centers for Disease Control:The Health Benefits of Smoking Cessation. A Report of the Surgeon General, 1990, DHHS Publication No. (CDC) 90–8416. Rockville, MD: Public Health Service, Office of Smoking and Health, 1990.Google Scholar
  4. (4).
    Fielding JE: Smoking: Health effects and control (Part I of II).New England Journal of Medicine. 1985,313:491–498.PubMedGoogle Scholar
  5. (5).
    Wetzler HP, Ursano RJ: A positive association between physical health practices and psychological well-being.Journal of Nervous and Mental Diseases. 1988,776:280–283.Google Scholar
  6. (6).
    Waal-Manning HJ, deHamel FA: Smoking habit and psychometric scores: A community study.New Zealand Medical Journal. 1978,88:188–191.PubMedGoogle Scholar
  7. (7).
    Glassman AH, Helzer JE, Covey LS, et al: Smoking, smoking cessation, and major depression.Journal of the American Medical Association. 1990,264:1546–1549.PubMedCrossRefGoogle Scholar
  8. (8).
    Anda RF, Williamson DF, Escobedo LG, et al: Depression and the dynamics of smoking.Journal of the American Medical Association. 1990,264:1541–1545.PubMedCrossRefGoogle Scholar
  9. (9).
    Breslau N, Kilbey MM, Andreski P: Nicotine dependence, major depression, and anxiety in young adults.Archives of General Psychiatry. 1991,48:1069–1074.PubMedGoogle Scholar
  10. (10).
    Frerichs RR, Aneshensel CS, Clark VA, et al: Smoking and depression: A community survey.American Journal of Public Health. 1981,71:637–640.PubMedCrossRefGoogle Scholar
  11. (11).
    Lundman BM, Apslund K, Norberg A: Smoking and metabolic control in patients with insulin-dependent diabetes mellitus.Journal of Internal Medicine. 1990,227:101–106.PubMedCrossRefGoogle Scholar
  12. (12).
    Guralnik JM, Kaplan GA: Predictors of healthy aging: Prospective evidence from the Alameda County Study.American Journal of Public Health. 1989,79:703–708.PubMedGoogle Scholar
  13. (13).
    LaCroix AZ, Guralnik JM, Berkman LF, et al: Maintaining mobility in later life II. Smoking, alcohol consumption, physical activity, and body mass index.American Journal of Epidemiology. 1993,137:858–869.PubMedGoogle Scholar
  14. (14).
    Hughes JR, Higgens ST, Hatsukami D: Effects of abstinence from tobacco. In Kozlowski LT, Annis HM, Cappell HD, et al (eds),Research Advances in Alcohol and Drug Problems (Vol 10). New York: Plenum Publishing Corp., 1990.Google Scholar
  15. (15).
    Pederson LL, Wanklin JM, Lefcoe NM: Self-reported long-term smoking cessation in patients with respiratory disease: Prediction of success and perception of health effects.International Journal of Epidemiology. 1988,17:804–809.PubMedCrossRefGoogle Scholar
  16. (16).
    Killen JD, Fortmann SP, Newman B, et al: Prospective study of factors influencing the development of craving associated with smoking cessation.Psychopharmacology. 1991,105:191–196.PubMedCrossRefGoogle Scholar
  17. (17).
    Shiftman S: The tobacco withdrawal syndrome. In Krasnegor NA (ed),Cigarette Smoking as a Dependence Process (NIDA Research Monograph 23). Washington, DC: U.S. Department of Health, Education and Welfare, 1979.Google Scholar
  18. (18).
    Gritz ER, Carr CR, Marcus AC: The tobacco withdrawal syndrome in unaided quitters.British Journal of Addiction. 1991,86:57–69.PubMedCrossRefGoogle Scholar
  19. (19).
    Fortmann SP, Killen JD: Who shall quit? Comparison of volunteer and population-based recruitment in two minimal-contact smoking cessation studies.American Journal of Epidemiology. 1994,140:39–51.PubMedGoogle Scholar
  20. (20).
    Stewart AL, Sherbourne CD, Hays RD, et al: Summary and discussion of MOS measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Weil-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992.Google Scholar
  21. (21).
    McDowell IY, Newell C:Measuring Health: A Guide to Rating Scales and Questionnaires. New York: Oxford University Press, 1987.Google Scholar
  22. (22).
    Stewart AL: A framework of health concepts. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 12.Google Scholar
  23. (23).
    Hays RD, Stewart AL: Construct validity of MOS health measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 325.Google Scholar
  24. (24).
    Hays RD, Stewart AL: The structure of self-reported health in chronic disease patients.Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990,2:22–30.Google Scholar
  25. (25).
    Stewart AL, Hays RD, Ware Jr. JE: The MOS Short-Form General Health Survey: Reliability and validity in a patient population.Medical Care. 1988,26:724–735.PubMedCrossRefGoogle Scholar
  26. (26).
    Ware Jr. JE, Sherbourne CD, Davies AR: Developing and testing the MOS 20-item Short-Form Health Survey: A general population application. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Weil-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 277.Google Scholar
  27. (27).
    Wells KB, Stewart A, Hays RD, et al: The functioning and well-being of depressed patients: Results from the Medical Outcomes Study.Journal of the American Medical Association. 1989,262: 914–919.PubMedCrossRefGoogle Scholar
  28. (28).
    Stewart AL, Greenfield S, Hays RD, et al: Functional status and well-being of patients with chronic conditions: Results from the Medical Outcomes Study.Journal of the American Medical Association, 1989,262:907–913.PubMedCrossRefGoogle Scholar
  29. (29).
    Stewart AL, Hays RD, Ware Jr. JE: Health perceptions, energy/fatigue, and health distress measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 143.Google Scholar
  30. (30).
    Ware Jr. JE, Sherbourne CD: The MOS 36-Item Short-Form Health Survey (SF-36): I. Conceptual framework and item selection.Medical Care. 1992,30:473–483.PubMedCrossRefGoogle Scholar
  31. (31).
    Stewart AL, Ware Jr. JE, Sherbourne CD, et al: Psychological distress/well-being and cognitive functioning measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 102.Google Scholar
  32. (32).
    Hays RD, Stewart AL: Sleep measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 235.Google Scholar
  33. (33).
    Rosenberg M:Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press, 1965.Google Scholar
  34. (34).
    Pearlin LI, Menaghan EG, Lieberman MA, et al: The stress process.Journal of Health and Social Behavior. 1981,22:337–356.PubMedCrossRefGoogle Scholar
  35. (35).
    Stewart AL, Hays RD, Ware Jr. JE: Methods of validating health measures. In Stewart AL, Ware Jr. JE (eds),Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992, 309.Google Scholar
  36. (36).
    Cohen S, Kamarck T, Mermelstein R: A global measure of perceived stress.Journal of Health and Social Behavior. 1983,24: 385–396.PubMedCrossRefGoogle Scholar
  37. (37).
    RadlofF LS: The CES-D scale: A self-report depression scale for research in the general population.Applied Psychological Measurement. 1977,1:385–401.CrossRefGoogle Scholar
  38. (38).
    Cohen S, Mermelstein R, Kamarck T, et al: Measuring the functional components of social support. In Sarason EG, Sarason BR (eds),Social Support: Theory, Research, and Applications. Boston, MA: Martinus Nighoff, 1985.Google Scholar
  39. (39).
    Stewart AL, Brook RH, Kane RL:Conceptualization and Measurement of Health Habits for Adults in the Health Insurance Study: Vol. II, Overweight (R-2374-2-HEW). Santa Monica, CA: The Rand Corporation, 1980.Google Scholar
  40. (40).
    Killen JD, Fortmann SP, Kraemer HC, et al: Who will relapse? Symptoms of nicotine dependence predict long-term relapse after smoking cessation.Journal of Consulting and Clinical Psychology. 1992,60:797–801.PubMedCrossRefGoogle Scholar
  41. (41).
    Fortmann SP, Killen JD: Nicotine gum and self-help behavioral treatment for smoking relapse prevention: Results from a trial using population-based recruitment.Journal of Consulting and Clinical Psychology. 1995,63:460–468.PubMedCrossRefGoogle Scholar
  42. (42).
    Larzelere RE, Mulaik SA: Single-sample tests for many correlations.Psychological Bulletin. 1977,84:557–569.CrossRefGoogle Scholar
  43. (43).
    Pocock SJ, Geller NL, Tsiatis AA: The analysis of multiple end-points in clinical trials.Biometrics. 1987,43:487–498.PubMedCrossRefGoogle Scholar
  44. (44).
    Cohen J: A power primer.Psychological Bulletin. 1992,112:155–159.CrossRefPubMedGoogle Scholar
  45. (45).
    McHorney CA, Ware Jr. JE, Raczek AE: The MOS 36-Item Short Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs.Medical Care. 1993,31:247–263.PubMedCrossRefGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 1995

Authors and Affiliations

  • Anita L. Stewart
    • 1
  • Abby C. King
    • 1
    • 2
  • Joel D. Killen
    • 2
  • Philip L. Ritter
    • 2
  1. 1.School of NursingUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Stanford Medical SchoolStanford
  3. 3.Institute for Health & AgingUniversity of CaliforniaSan Francisco

Personalised recommendations