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Impact of self-reported smoking status on health-related quality of life in Singapore



To evaluate possible differences in health-related quality of life (HRQoL) according to self-reported smoking status in a multiethnic urban Asian population in Singapore.

Subjects and methods

In this community-based cross-sectional survey of a stratified random sample, interviewers obtained socioeconomic, clinical and HRQoL—Short Form-36, Version 2 (SF-36v2), Health Utilities Index Mark 3 (HUI3) and EuroQoL 5-Dimensions (EQ-5D)—data in English, Chinese or Malay. The association between self-reported smoking status and HRQoL at the overall scale and individual attribute levels stratified by gender were evaluated using regression analyses.


Of 3,006 consenting participants with a mean age of 48 (SD: 16.44) years, 49.9 % males, Chinese: Malay: Indian = 49.9 %: 25.3 %: 24.8 %, 727 (34.4 %) male and 1,386 (65.6 %) female are never smokers, 208 (86.7 %) male and 32 (13.3 %) female are ex-smokers, 104 (78.8 %) male and 28 (21.2 %) female are occasional smokers, while 460 (88.3 %) male and 61 (11.7 %) female are regular smokers. After adjusting for socioeconomic and clinical variables, male ex-smokers reported lower SF-36v2 MCS (regression coefficient: −1.60, P = 0.026) and HUI3 utility scores (regression coefficient: −0.024, P = 0.040) compared to never smokers. Female regular smokers reported lower HUI3 utility scores as compared to never smokers (regression coefficient: −0.056, P = 0.004).


Compared with never smokers, male ex-smokers and female regular smokers reported poorer HRQoL in this multiethnic Asian study.

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This work was supported by programme grant 03/1/27/18/226 from the Biomedical Research Council of Singapore.

Conflict of interest

Dr Hwee-Lin Wee received an independent investigator-initiated research grant from Pfizer for the study “Developing Employer- Supported Workplace- based Smoking Cessation Programmes in Medium and Large Enterprises in Singapore”. However, the present manuscript is unrelated to the research grant.

David Feeny has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada. HUInc. distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of HUI.

All other authors declare no conflict of interest. All authors have access to the data and a role in writing the manuscript.

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Correspondence to Julian Thumboo.

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Gan, H.P., Wee, H.L., Cheung, Y.B. et al. Impact of self-reported smoking status on health-related quality of life in Singapore. J Public Health 21, 389–401 (2013).

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  • Asia
  • Smoking
  • Quality of life
  • Healthcare
  • Singapore