Ozga Jenny E, Sargent James D, Steinberg Alexander W, Tang Zhiqun, Stanton Cassandra A, Paulin Laura M
Behavioral Health and Health Policy, Westat, Rockville, United States.
Department of Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, United States.
Tob Induc Dis. 2025 Jul 23;23. doi: 10.18332/tid/204009. eCollection 2025.
Childhood smoking onset is associated with chronic obstructive pulmonary disease (COPD), independent of current smoking and smoking history. Its association with lower quality of life has not been tested. We examined the association between childhood smoking and measures of global health among older US adults.
This study involved a cross-sectional survey of US adults ≥40 years (n=7056) from Wave 5 (2019) of the Population Assessment of Tobacco and Health Study. Ever smokers were asked when they began smoking regularly. Weighted multivariable analysis assessed onset of regular smoking at age of <15 years as a risk factor for lower Patient-Reported Outcomes Measurement Information System Global Physical and Mental Health (GPH and GMH) scores, adjusting for current smoking, smoking intensity, cigarette pack-years, secondhand smoke exposure, and other covariates. Sensitivity analysis added smoking-related disease comorbidities (e.g. COPD).
Sociodemographics were reflective of the US population aged ≥40 years, with 6.8% reporting childhood smoking and 16.9% current smoking. Mean (SD) for GPH and GMH were 14.8 (3.1) and 14.5 (3.8), respectively. In the multivariable analysis, compared to onset smoking at an older childhood age, GPH and GMH were significantly lower for those with early onset of smoking (-4.27%; 95% CI: -6.52 - -1.97 and -3.34%; 95% CI: -6.08 - -0.52; respectively). Global health was also negatively associated with current smoking, higher pack-years, and secondhand smoke exposure. The association between childhood smoking and GPH (but not GMH) remained significant after further adjustment for disease mediators.
Childhood smoking was independently associated with lower quality of life among adults aged ≥40 years. Adverse effects of smoking on development during adolescence may have implications that extend beyond associations with chronic disease.
儿童期开始吸烟与慢性阻塞性肺疾病（COPD）相关，独立于当前吸烟情况和吸烟史。其与生活质量较低的关联尚未得到验证。我们研究了美国老年成年人中儿童期吸烟与总体健康指标之间的关联。
本研究涉及对烟草与健康人口评估研究第5波（2019年）中年龄≥40岁的美国成年人（n = 7056）进行的横断面调查。曾经吸烟者被问及他们开始定期吸烟的时间。加权多变量分析将15岁之前开始定期吸烟作为患者报告结局测量信息系统总体身心健康（GPH和GMH）得分较低的危险因素进行评估，同时对当前吸烟情况、吸烟强度、吸烟包年数、二手烟暴露及其他协变量进行校正。敏感性分析纳入了吸烟相关疾病合并症（如COPD）。
社会人口统计学特征反映了美国40岁及以上人群的情况，6.8%报告有儿童期吸烟史，16.9%为当前吸烟者。GPH和GMH的均值（标准差）分别为14.8（3.1）和14.5（3.8）。在多变量分析中，与儿童期较晚开始吸烟相比，吸烟较早开始者的GPH和GMH显著更低（分别为-4.27%；95%CI：-6.52至-1.97和-3.34%；95%CI：-6.08至-0.52）。总体健康状况也与当前吸烟、较高的吸烟包年数和二手烟暴露呈负相关。在进一步校正疾病介导因素后，儿童期吸烟与GPH（而非GMH）之间的关联仍然显著。
儿童期吸烟与40岁及以上成年人的生活质量较低独立相关。吸烟对青少年发育的不良影响可能具有超出与慢性病关联的意义。
