Smokers at increased risk for non-life threatening health conditions and reduced quality of life in old age

Smokers, as well as former smokers, who survive into old age, are at a heightened risk for non-life threatening ailments that can reduce quality of life and expand the need for health services, according to a cohort study conducted by Benjamin A. Shaw, associate professor, in conjunction with the Aging Research Center at the Karolinska Institute in Stockholm, Sweden. The study, Smoking trajectories from midlife to old age and the development of non-life-threatening health problems: A 34-year prospective cohort study was published in Prevention Medicine.  While several previous studies have reported and confirmed correlations between tobacco smoking and numerous life-threatening diseases, this study uniquely investigates the association between smoking trajectories, including the amount and continuance of smoking, and the progression of three prevalent non-life threatening conditions: mobility impairment, musculoskeletal pain, and symptoms of psychological distress.

Data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) combined with data from the Swedish Level of Living Survey (LNU) allowed for 34 years of follow-up of a sample of 1060 Swedish adults aged 30-50 at baseline. The three health indicators and smoking status were assessed at four periods from 1968 to 2002. Based on the smoking status classifications of current non- smoking, light smoking, or heaving smoking, each person’s smoking pattern over time was distinguished and used as predictors of differences in health trajectories.

While mobility impairment showed no differences between smoking trajectory groups at baseline, over time all smokers and former smokers exhibited earlier onset and more rapid rises in mobility problems compared with persistent non-smokers, possibly due to higher frequency of lung problems, cardiovascular diseases, and stroke related to smoking. Persistent heavy smokers demonstrated raised levels of psychological distress at baseline and over time. Furthermore, while not statistically significant, all smoking groups stated they had more pain symptoms than the non-smokers at baseline and over time.

Perhaps the most surprising finding to researchers was that the health trajectories of individuals who quit smoking were more similar to those of persistent smokers than persistent non-smokers during follow-up. These similarities may be the result of damage caused by many years of smoking that is now irreversible at such an advanced age. Risk for health problems in former smokers may also be higher due to health problems being the motive for smoking cessation in many individuals. More studies need to be conducted on this issue, as an expanding population of adults with a history of smoking reaches old age, develops chronic health problems, and presents substantial demands on our health care system.

Click here to read the study.