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. 2018 May:110:38-46.
doi: 10.1016/j.ypmed.2018.02.006. Epub 2018 Feb 7.

Improvements in health-related quality of life among smokers who quit after hospitalization

Douglas E Levy  1 , Yuchiao Chang  2 , Susan Regan  3 , Hilary A Tindle  4 , Daniel E Singer  2 , Nancy A Rigotti  5
Affiliations

Improvements in health-related quality of life among smokers who quit after hospitalization

Douglas E Levy et al. Prev Med. 2018 May.

Abstract

Few rigorous longitudinal assessments have examined health-related quality of life (HRQoL) changes after smoking cessation, especially among recently-hospitalized smokers. We compared the change in HRQoL between those who did or did not quit smoking 6 months after hospital discharge. Participants were 1357 smokers recruited for a cessation trial between 2012 and 2014 while hospitalized at two hospitals in Massachusetts and one in Pennsylvania. Cessation was defined as biochemically confirmed 7-day point prevalence abstinence at 6 months or as self-reported continuous abstinence at 1, 3, or 6 months post discharge. HRQoL measures included a single-item global health measure (SF1); the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) screening tool for psychological distress; and the EQ-5D-5L health utilities measure. Multivariable models controlled for age, sex, race, education, insurance, study site, study arm, discharge diagnoses, and baseline HRQoL. Improvements in HRQoL were evident in the first month after discharge among those achieving abstinence compared to continuing smokers. At 6 months post-discharge, those with biochemically confirmed cessation were 30% more likely to report at least good health by the SF1 (aRR 95% CI 1.14-1.45), 19% less likely to screen positive for psychological distress (aRR, 95% CI 0.68-0.93), and had EQ-5D-5L health utility scores 0.05 points (95% CI 0.02-0.08) higher than continuing smokers. Results were similar when assessed as a function of self-reported cessation. Hospital-initiated smoking cessation is associated with rapid statistically and clinically significant improvements in a range of HRQoL measures, providing an additional tool clinicians and health systems could use to encourage smoking cessation.

Keywords: Health-related quality of life; Smoking cessation; Tobacco.

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Conflict of interest statement

Conflicts of Interest

Dr. Rigotti receives royalties from UpToDate. Dr. Rigotti has been an unpaid consultant for Pfizer, Inc., and Optum, Inc., regarding smoking cessation. She has received travel expenses from Pfizer to attend a consultant meeting for which she received no honorarium. Dr. Levy has been a paid consultant to CVS, Inc., to provide expertise on tobacco policy. Dr. Singer has been a paid consultant for Pfizer, Inc., but on matters separate from smoking cessation.

Figures

Figure 1.
Figure 1.. SF1 scores as a function of tobacco abstinence
Month 0 is baseline. The research took place at MGH, NSMC, and UPMC from 2012–2014.
Figure 1.
Figure 1.. SF1 scores as a function of tobacco abstinence
Month 0 is baseline. The research took place at MGH, NSMC, and UPMC from 2012–2014.
Figure 2.
Figure 2.. PHQ-4 scores as a function of tobacco abstinence
Month 0 is baseline. The research took place at MGH, NSMC, and UPMC from 2012–2014.
Figure 3.
Figure 3.. EQ-5D-5L scores as a function of tobacco abstinence
Month 0 is baseline. The research took place at MGH, NSMC, and UPMC from 2012–2014.
See this image and copyright information in PMC

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