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Am Fam Physician. 2004;70(9):1785-1786

Smoking has been shown to have a negative impact on health-related quality of life (HRQL). Multiple studies have shown a significant difference in mean scores on a standardized quality-of-life questionnaire between never-smokers, current smokers, and ex-smokers. Another study of persons who were older than 55 years found similar results. Most of these studies assess older populations that may have other comorbidities or unrecognized smoking-related disorders. Currently, there are no studies that assess the HRQL of young persons with a short smoking history. Martinez and associates evaluated the HRQL in a selected population of healthy young smokers.

Participants were sampled randomly from the student population at two public universities and asked to complete a questionnaire that included the 36-item short form (SF-36) on health-related quality of life and a second form that concerned the presence of health disorders, tobacco smoking, and the use of medications, alcohol, and illicit drugs. The SF-36 covers nine health-related concepts, including physical function, physical role, pain index, vitality, social function, emotional role, general health perceptions, mental health index, and health transition. Participants in the study who were smokers and had no comorbidities were compared with a control group of healthy never-smokers.

There were 279 participants in the study, of whom 112 (40 percent) were smokers and 167 (60 percent) were never-smokers. Participants were excluded from the study if they were older than 25 years, had a health condition, used chronic medications, or used illicit drugs. The final groups included 77 smokers and 97 never-smokers. The clinical features between the smoking and control groups were similar. The smokers started at a mean age of 17.5 years, and had a mean smoking duration of 3.2 years and a 1.7 pack-year history. The smokers were divided into light smokers (fewer than 15 cigarettes per day), moderate smokers (15 to 24 cigarettes per day), and heavy smokers (25 or more cigarettes per day). The majority of smokers (75 participants) were in the light to moderate groups. The never smokers showed higher mean quality-of-life scores than smokers in all domains on the SF-36. The never-smokers scored higher (statistically significant) scores in the following domains: physical function, general health perceptions, vitality, social function, and mental health index.

The authors conclude that healthy, light to moderate smokers with a short smoking history have a significant impairment in HRQL compared with those who never smoked. They add that this impairment may be a result of the action of tobacco-generated substances or of intrinsic psychologic features. Better understanding of the aspects of these results could assist physicians in developing smoking-cessation plans with their patients.

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Copyright © 2004 by the American Academy of Family Physicians.

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