Østbye Truls, Taylor Donald Hugh, Jung Sang-Hyuk
Department of Community and Family Medicine, Duke University, Durham, North Carolina 27710, USA.
Prev Med. 2002 Mar;34(3):334-45. doi: 10.1006/pmed.2001.0991.
While the effects of smoking and other modifiable risk factors on mortality and specific diseases are well established, their effects on ill health more generally are less known. Using two national, longitudinal surveys, the objective of this study was to analyze the effect of smoking and other modifiable risk factors on ill health, defined in a multidimensional fashion (i.e., disability, impaired mobility, health care utilization, and self-reported health).
The analyses were based on the Health and Retirement Study (HRS) (12,652 persons 50-60 years old surveyed in 1992, 1994, 1996, and 1998) and the Asset and Health Dynamics among the Oldest Old survey (8,124 persons 60-70 years old surveyed in 1993, 1996, and 1998).
Smoking was strongly related to mortality and to ill health, with similar relative effects in the middle-aged and the elderly. There were consistent adverse dose-response relationships between smoking and ill health in the HRS. Persons who had quit smoking at least 15 years prior to the survey were no more likely than never smokers to experience ill health. A dose-response relationship was found between exercise and ill health. For body mass index and alcohol, there were U-shaped relationships with ill health.
Public health efforts designed to encourage smoking cessation should emphasize improvements in ill health in addition to decreased mortality.
虽然吸烟及其他可改变的风险因素对死亡率和特定疾病的影响已得到充分证实，但其对整体健康不佳状况的影响却鲜为人知。本研究利用两项全国性纵向调查，旨在分析吸烟及其他可改变的风险因素对以多维方式定义的健康不佳状况（即残疾、行动不便、医疗保健利用和自我报告的健康状况）的影响。
分析基于健康与退休研究（HRS）（1992年、1994年、1996年和1998年对12,652名50 - 60岁的人进行了调查）以及最年长者资产与健康动态调查（1993年、1996年和1998年对8,124名60 - 70岁的人进行了调查）。
吸烟与死亡率和健康不佳状况密切相关，在中年人和老年人中具有相似的相对影响。在HRS中，吸烟与健康不佳状况之间存在一致的不良剂量反应关系。在调查前至少15年戒烟的人出现健康不佳状况的可能性并不比从不吸烟者更高。运动与健康不佳状况之间存在剂量反应关系。对于体重指数和酒精，与健康不佳状况呈U形关系。
旨在鼓励戒烟的公共卫生努力除了降低死亡率外，还应强调改善健康不佳状况。
