Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom.
Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, United Kingdom.
PLoS One. 2018 Nov 20;13(11):e0205992. doi: 10.1371/journal.pone.0205992. eCollection 2018.
Previous studies have shown that smoking and smoking cessation may be associated with health-related quality of life (HRQoL). In this study, we compared changes in HRQoL in people who maintained abstinence with people who had relapsed to smoking.
This was a secondary analysis of data from a trial of a relapse prevention intervention in 1,407 short-term quitters. The European Quality of Life -5 Dimensions (EQ-5D) measured HRQoL at baseline, 3 and 12 months. Smoking outcome was continuous abstinence from 2 to 12 months, and 7-day smoking at 3 and 12 months. We used nonparametric test for differences in EQ-5D utility scores, and chi-square test for dichotomised response to each of the five EQ-5D dimensions. Multivariable regression analyses were conducted to evaluate associations between smoking relapse and HRQoL or anxiety/depression problems.
The mean EQ-5D tariff score was 0.8252 at baseline. People who maintained abstinence experienced a statistically non-significant increase in the EQ-5D score (mean change 0.0015, P = 0.88), while returning to smoking was associated with a statistically significant decrease in the EQ-5D score (mean change -0.0270, P = 0.004). After adjusting for multiple baseline characteristics, the utility change during baseline and 12 months was statistically significantly associated with continuous abstinence, with a difference of 0.0288 (95% CI: 0.0006 to 0.0571, P = 0.045) between relapsers and continuous quitters. The only difference in quality of life dimensions between those who relapsed and those who maintained abstinence was in the proportion of participants with anxiety/depression problems at 12 months (30% vs. 22%, P = 0.001). Smoking relapse was associated with a simultaneous increase in anxiety/depression problems.
People who achieve short-term smoking abstinence but subsequently relapse to smoking have a reduced quality of life, which appears mostly due to worsening of symptoms of anxiety and depression. Further research is required to more fully understand the relationship between smoking and health-related quality of life, and to develop cessation interventions by taking into account the impact of anxiety or depression on smoking.
先前的研究表明，吸烟和戒烟可能与健康相关生活质量（HRQoL）有关。在这项研究中，我们比较了保持戒烟状态和重新吸烟的人之间 HRQoL 的变化。
这是对一项复发预防干预试验中 1407 名短期戒烟者数据的二次分析。欧洲生活质量-5 维度（EQ-5D）在基线、3 个月和 12 个月时测量 HRQoL。吸烟结局是 2 至 12 个月的持续戒烟，以及 3 个月和 12 个月的 7 天吸烟。我们使用非参数检验比较 EQ-5D 效用评分的差异，使用卡方检验比较五个 EQ-5D 维度的二分响应。进行多变量回归分析以评估吸烟复发与 HRQoL 或焦虑/抑郁问题之间的关联。
基线时 EQ-5D 关税评分的平均值为 0.8252。保持戒烟的人 EQ-5D 评分有统计学上的非显著增加（平均变化 0.0015，P=0.88），而重新吸烟与 EQ-5D 评分的统计学显著下降相关（平均变化-0.0270，P=0.004）。调整多个基线特征后，基线和 12 个月期间的效用变化与持续戒烟有统计学显著关联，复发者与持续戒烟者之间的差异为 0.0288（95%CI：0.0006 至 0.0571，P=0.045）。在生活质量维度方面，复发者和持续戒烟者之间唯一的差异是 12 个月时焦虑/抑郁问题的参与者比例（30%对 22%，P=0.001）。吸烟复发与焦虑/抑郁问题的同时加重有关。
短期戒烟但随后重新吸烟的人生活质量降低，这主要是由于焦虑和抑郁症状恶化所致。需要进一步研究以更全面地了解吸烟与健康相关生活质量之间的关系，并通过考虑焦虑或抑郁对吸烟的影响来开发戒烟干预措施。
