Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nicotine Tob Res. 2024 Jun 21;26(7):913-921. doi: 10.1093/ntr/ntad157.
This study aimed to determine the sex-specific effects of active and passive cigarette smoking on the full spectrum of health-related quality of life (HRQoL) among a sizeable adult population.
This study was conducted within the Tehran Lipid and Glucose Study (TLGS) framework. Participants included 7478 adults in the last examination of the TLGS. We used a quantile regression model to compare sex-specific HRQoL distributions among non-, current, and passive smokers. Two-step cluster analysis was used to consider the synergic effects of confounder variables.
In men, current smoking was negatively associated with only mental HRQoL in all percentiles of its distribution with a decrease in absolute estimation values from the lowest (5th: β = -6.59, p < .001) to the highest (90th: β=-0.93, p = .027). Also, passive smoking was negatively associated with men's physical HRQoL in the upper percentiles of its distribution (75th: β = -1.12, p = .010; 90th: β = -1.26, p = .016). In women, the current (β = -4.17 to -4.45 for 25th to 90th percentiles) and passive smokers (β = -2.05 to -4.25 for 10th to 90th percentiles) had lower mental HRQoL in the mentioned percentiles. Also, the current smoking had a negative association with the 5th percentile (β = -2.04, p = .008), and a positive association with the 50th (β = 1.94, p < .008) and 75th percentile of physical HRQoL (β = 2.25, p = .004).
The present study showed the harmful effect of smoking on mental HRQol in all participants. In contrast, the physical effect of smoking was only observed in female active smokers and at the extreme levels of the physical HRQoL spectrum.
According to the harmful effect of smoking on HRQoL, understanding active and passive smokers' perceptions of how smoking impacts their health is critical for tobacco control programs. Since most previous studies of smoking and HRQoL have mainly focused on the extreme parts or central values of the HRQoL distribution, the use of a multiple regression approach enables the evaluation of other parts of the conditional distribution of the outcome variable. This study demonstrated the prominent effect of smoking on the mental HRQoL as well as the more serious public health burden of passive smoking in women.
本研究旨在确定主动和被动吸烟对相当大的成年人群体健康相关生活质量（HRQoL）全谱的性别特异性影响。
本研究是在德黑兰血脂和血糖研究（TLGS）框架内进行的。参与者包括 TLGS 最后一次检查中的 7478 名成年人。我们使用分位数回归模型比较非吸烟者、当前吸烟者和被动吸烟者之间的性别特异性 HRQoL 分布。两步聚类分析用于考虑混杂变量的协同效应。
在男性中，当前吸烟与所有百分位的精神 HRQoL 呈负相关，其绝对估计值从最低（第 5 百分位：β=-6.59，p<0.001）到最高（第 90 百分位：β=-0.93，p=0.027）。此外，被动吸烟与男性上部分位数的身体 HRQoL 呈负相关（第 75 百分位：β=-1.12，p=0.010；第 90 百分位：β=-1.26，p=0.016）。在女性中，当前吸烟者（第 25 至 90 百分位的β=-4.17 至-4.45）和被动吸烟者（第 10 至 90 百分位的β=-2.05 至-4.25）的精神 HRQoL 较低。此外，当前吸烟与精神 HRQoL 的第 5 百分位（β=-2.04，p=0.008）呈负相关，与第 50 百分位（β=1.94，p<0.008）和第 75 百分位（β=2.25，p=0.004）呈正相关。
本研究表明，吸烟对所有参与者的精神 HRQoL 都有有害影响。相比之下，吸烟对身体的影响仅在女性主动吸烟者和身体 HRQoL 光谱的极端水平观察到。
根据吸烟对 HRQoL 的有害影响，了解主动和被动吸烟者对吸烟如何影响其健康的看法对于烟草控制计划至关重要。由于大多数先前关于吸烟和 HRQoL 的研究主要集中在 HRQoL 分布的极端部分或中心值，因此使用多元回归方法可以评估因变量条件分布的其他部分。本研究表明，吸烟对精神 HRQoL 有显著影响，而且被动吸烟对女性的公共卫生负担更为严重。
