Smoking status and quality of life: a longitudinal study among adults with disabilities

BACKGROUND: Current research suggests that people with disabilities are more likely to use tobacco, less likely to quit, and less likely to be screened for tobacco use. However, little is known about the impact of changes in smoking status on the health-related quality of life (HRQL) of people with disabilities. OBJECTIVE: The primary objective of this paper is to examine the association between changes in HRQL and smoking status over time among people with disabilities. METHODS: The study data were derived from the Massachusetts Survey of Secondary Conditions, a longitudinal survey of adults with disabilities; Phase I was conducted in 1996-1998, Phase II in 1998-1999, and Phase III in 1999-2000. The main outcome measure was HRQL as measured by the Medical Outcomes Study Short Form-36 (SF-36). Analysis was primarily done in 2003. RESULTS: Current smokers and those who began smoking during follow-up had significantly poorer HRQL compared with nonsmokers with disabilities. Longitudinal analysis suggests that controlling for age, gender, race/ethnicity, education, and activities of daily living, changes in HRQL scores over time were associated with changes in smoking status. Compared to smokers, those who quit smoking during follow-up experienced a significant improvement in mean SF-36 scores over time for the dimensions of mental health, energy and vitality, and general health. CONCLUSIONS: Findings from this study highlight a strong need to inform public health programs, people with disabilities and healthcare providers about the association between tobacco cessation and improved health-related quality of life among people with disabilities.