Skip to main content
American Journal of Public Health logoLink to American Journal of Public Health
. 1999 May;89(5):691–698. doi: 10.2105/ajph.89.5.691

The impact of smoking, alcohol consumption, and physical activity on use of hospital services.

N Haapanen-Niemi 1, S Miilunpalo 1, I Vuori 1, M Pasanen 1, P Oja 1
PMCID: PMC1508744  PMID: 10224980

Abstract

OBJECTIVES: This study investigated the associations of smoking, excess alcohol consumption, and physical inactivity with the use of hospital care. METHODS: A cohort of 19- to 63-year-old Finnish men (n = 2534) and women (n = 2668) were followed prospectively for 16 years. Number of hospital days was extracted from the national hospital discharge registry, while data concerning exposure variables were derived from the baseline questionnaire. RESULTS: After adjustment for confounders, male smokers had 70% (95% confidence interval [CI] = 49%, 95%) and female smokers had 49% (95% CI = 29%, 71%) more hospital days due to my cause than did those who had never smoked. Men consuming a moderate amount of alcohol had 21% (95% CI = 10%, 31%) fewer hospital days due to any cause than did nondrinkers. Men who had the lowest energy expenditure during leisure-time physical activity had 36% (95% CI = 15%, 63%) more hospital days than the most active men. The figure for women was 23% (95% CI = 4%, 44%). CONCLUSIONS: Smoking was strongly associated with an increased use of hospital services. The associations of alcohol consumption and leisure-time physical activity with use of hospital care depended on the diagnosis under study.

Full text

PDF
691

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armstrong M. A., Klatsky A. L. Alcohol use and later hospitalization experience. Med Care. 1989 Dec;27(12):1099–1108. doi: 10.1097/00005650-198912000-00002. [DOI] [PubMed] [Google Scholar]
  2. Bartecchi C. E., MacKenzie T. D., Schrier R. W. The human costs of tobacco use (1) N Engl J Med. 1994 Mar 31;330(13):907–912. doi: 10.1056/NEJM199403313301307. [DOI] [PubMed] [Google Scholar]
  3. Benzeval M., Judge K. The determinants of hospital utilisation: implications for resource allocation in England. Health Econ. 1994 Mar-Apr;3(2):105–116. doi: 10.1002/hec.4730030207. [DOI] [PubMed] [Google Scholar]
  4. Berlin J. A., Colditz G. A. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol. 1990 Oct;132(4):612–628. doi: 10.1093/oxfordjournals.aje.a115704. [DOI] [PubMed] [Google Scholar]
  5. Blose J. O., Holder H. D. Injury-related medical care utilization in a problem drinking population. Am J Public Health. 1991 Dec;81(12):1571–1575. doi: 10.2105/ajph.81.12.1571. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Freeborn D. K., Mullooly J. P., Pope C. R., McFarland B. H. Smoking and consistently high use of medical care among older HMO members. Am J Public Health. 1990 May;80(5):603–605. doi: 10.2105/ajph.80.5.603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Friedman G. D., Klatsky A. L. Is alcohol good for your health? N Engl J Med. 1993 Dec 16;329(25):1882–1883. doi: 10.1056/NEJM199312163292510. [DOI] [PubMed] [Google Scholar]
  8. Haapanen N., Miilunpalo S., Pasanen M., Oja P., Vuori I. Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. Am J Epidemiol. 1997 Apr 15;145(8):762–769. doi: 10.1093/aje/145.8.762. [DOI] [PubMed] [Google Scholar]
  9. Haapanen N., Miilunpalo S., Vuori I., Oja P., Pasanen M. Association of leisure time physical activity with the risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. Int J Epidemiol. 1997 Aug;26(4):739–747. doi: 10.1093/ije/26.4.739. [DOI] [PubMed] [Google Scholar]
  10. Haapanen N., Miilunpalo S., Vuori I., Oja P., Pasanen M. Characteristics of leisure time physical activity associated with decreased risk of premature all-cause and cardiovascular disease mortality in middle-aged men. Am J Epidemiol. 1996 May 1;143(9):870–880. doi: 10.1093/oxfordjournals.aje.a008830. [DOI] [PubMed] [Google Scholar]
  11. Hermanson T., Aro S., Bennett C. L. Finland's health care system. Universal access to health care in a capitalistic democracy. JAMA. 1994 Jun 22;271(24):1957–1962. [PubMed] [Google Scholar]
  12. Holman C. D., English D. R., Milne E., Winter M. G. Meta-analysis of alcohol and all-cause mortality: a validation of NHMRC recommendations. Med J Aust. 1996 Feb 5;164(3):141–145. doi: 10.5694/j.1326-5377.1996.tb122011.x. [DOI] [PubMed] [Google Scholar]
  13. Johansen H., Nair C., Bond J. Who goes to the hospital? An investigation of high users of hospital days. Health Rep. 1994;6(2):253–277. [PubMed] [Google Scholar]
  14. Klatsky A. L., Armstrong M. A., Friedman G. D. Red wine, white wine, liquor, beer, and risk for coronary artery disease hospitalization. Am J Cardiol. 1997 Aug 15;80(4):416–420. doi: 10.1016/s0002-9149(97)00388-3. [DOI] [PubMed] [Google Scholar]
  15. Klatsky A. L., Armstrong M. A., Friedman G. D. Relations of alcoholic beverage use to subsequent coronary artery disease hospitalization. Am J Cardiol. 1986 Oct 1;58(9):710–714. doi: 10.1016/0002-9149(86)90342-5. [DOI] [PubMed] [Google Scholar]
  16. Kujala U. M., Sarna S., Kaprio J., Koskenvuo M. Hospital care in later life among former world-class Finnish athletes. JAMA. 1996 Jul 17;276(3):216–220. [PubMed] [Google Scholar]
  17. LaCroix A. Z., Leveille S. G., Hecht J. A., Grothaus L. C., Wagner E. H. Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? J Am Geriatr Soc. 1996 Feb;44(2):113–120. doi: 10.1111/j.1532-5415.1996.tb02425.x. [DOI] [PubMed] [Google Scholar]
  18. Law M. R., Hackshaw A. K. A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect. BMJ. 1997 Oct 4;315(7112):841–846. doi: 10.1136/bmj.315.7112.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Malmivaara A., Heliövaara M., Knekt P., Reunanen A., Aromaa A. Risk factors for injurious falls leading to hospitalization or death in a cohort of 19,500 adults. Am J Epidemiol. 1993 Sep 15;138(6):384–394. doi: 10.1093/oxfordjournals.aje.a116871. [DOI] [PubMed] [Google Scholar]
  20. Miller J. E., Russell L. B., Davis D. M., Milan E., Carson J. L., Taylor W. C. Biomedical risk factors for hospital admission in older adults. Med Care. 1998 Mar;36(3):411–421. doi: 10.1097/00005650-199803000-00016. [DOI] [PubMed] [Google Scholar]
  21. Muller A. Alcohol consumption and community hospital admissions in the United States: a dynamic regression analysis, 1950-1992. Addiction. 1996 Feb;91(2):231–242. [PubMed] [Google Scholar]
  22. Nicholl J. P., Coleman P., Brazier J. E. Health and healthcare costs and benefits of exercise. Pharmacoeconomics. 1994 Feb;5(2):109–122. doi: 10.2165/00019053-199405020-00005. [DOI] [PubMed] [Google Scholar]
  23. Oja P., Laukkanen R., Pasanen M., Tyry T., Vuori I. A 2-km walking test for assessing the cardiorespiratory fitness of healthy adults. Int J Sports Med. 1991 Aug;12(4):356–362. doi: 10.1055/s-2007-1024694. [DOI] [PubMed] [Google Scholar]
  24. Poikolainen K. Alcohol and mortality: a review. J Clin Epidemiol. 1995 Apr;48(4):455–465. doi: 10.1016/0895-4356(94)00174-o. [DOI] [PubMed] [Google Scholar]
  25. Romelsjö A., Kaplan G. A., Cohen R. D., Allebeck P., Andreasson S. Protective factors and social risk factors for hospitalization and mortality among young men. Am J Epidemiol. 1992 Mar 15;135(6):649–658. doi: 10.1093/oxfordjournals.aje.a116344. [DOI] [PubMed] [Google Scholar]
  26. Vogt T. M., Schweitzer S. O. Medical costs of cigarette smoking in a health maintenance organization. Am J Epidemiol. 1985 Dec;122(6):1060–1066. doi: 10.1093/oxfordjournals.aje.a114187. [DOI] [PubMed] [Google Scholar]
  27. Wagner E. H., Curry S. J., Grothaus L., Saunders K. W., McBride C. M. The impact of smoking and quitting on health care use. Arch Intern Med. 1995 Sep 11;155(16):1789–1795. [PubMed] [Google Scholar]
  28. Wallerstedt S., Denison H., Sandström J., Westin J. The prevalence of alcoholism and its relation to cause of hospitalization and long-term mortality in male somatic inpatients. J Intern Med. 1995 Mar;237(3):339–344. doi: 10.1111/j.1365-2796.1995.tb01184.x. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES