Department of Biostatistics, Mailman School of Public Health and School of Nursing, Columbia University, New York, NY, USA.
Department of Community Health and Social Medicine, CUNY Medical School, New York, NY, USA.
J Public Health (Oxf). 2017 Dec 1;39(4):e194-e201. doi: 10.1093/pubmed/fdw096.
To estimate the impact of smoking on quality-adjusted life years (QALY) for US adults aged 65 years and older.
Using the 2003-08 National Health and Nutrition Examination Survey Linked Mortality File, we estimated the mean QALY throughout the remaining lifetime by participants' smoking status as well as smoking intensity and time since cessation.
Never, former and current smokers had a mean QALY of 16.1, 12.7 and 7.3 years, respectively. Among current smokers, those who started smoking before age 18 had fewer QALYs than those who started at or after age 18 (6.0 and 8.5 years, respectively) and those smoking ≥20 cigarettes per day had fewer QALYs than those smoking <20 cigarettes per day (6.6 and 8.1 years, respectively). QALYs also declined with a longer duration of smoking and a shorter time since cessation. The potential gains if a person quit smoking would be 5.4 QALYs, and the gains would increase with a longer time since quitting as well as quitting at a younger age.
This study demonstrated the dose-response effect of smoking status on QALY. The results indicate the health benefits of tobacco cessation at any age and sizeable losses for former or current smokers.
评估吸烟对美国 65 岁及以上成年人的质量调整生命年（QALY）的影响。
使用 2003-08 年国家健康和营养调查（NHANES）的链接死亡率文件，我们根据参与者的吸烟状况、吸烟强度和戒烟时间来估计他们剩余寿命的平均 QALY。
从不吸烟者、前吸烟者和现吸烟者的平均 QALY 分别为 16.1、12.7 和 7.3 年。在现吸烟者中，18 岁前开始吸烟的人比 18 岁及以后开始吸烟的人拥有更少的 QALY（分别为 6.0 和 8.5 年），每天吸烟≥20 支的人比每天吸烟<20 支的人拥有更少的 QALY（分别为 6.6 和 8.1 年）。吸烟时间越长、戒烟时间越短，QALY 也会减少。如果一个人戒烟，将获得 5.4 个 QALY 的潜在收益，而且随着戒烟时间的延长和戒烟年龄的提前，收益会增加。
本研究证明了吸烟状况对 QALY 的剂量反应效应。结果表明，任何年龄戒烟都有健康益处，而且前吸烟者或现吸烟者会有大量损失。
