Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Aug;54(8):566–574. doi: 10.1136/jech.54.8.566

Smoking and the compression of morbidity

W Nusselder 1, C Looman 1, P J M-v de Mheen 1, H van de Mheen 1, J Mackenbach 1
PMCID: PMC1731729  PMID: 10890867

Abstract

OBJECTIVE—To examine whether eliminating smoking will lead to a reduction in the number of years lived with disability (that is, absolute compression of morbidity).
DESIGN—Multistate life table calculations based on the longitudinal GLOBE study (the Netherlands) combined with the Longitudinal Study of Aging (LSOA, United States of America).
SETTING—the Netherlands.
SUBJECTS—Dutch nationals aged 30-74 years living in the city of Eindhoven and surrounding municipalities (GLOBE) and United States citizens age 70 and over (LSOA).
MAIN OUTCOME MEASURES—Life expectancy with and without disability and total life expectancy at ages 30 and 70.
RESULTS—A non-smoking population on balance spends fewer years with disability than a mixed smoking-non-smoking population. Although non-smokers have lower mortality risks and thus are exposed to disability over a longer period of time, their lower incidence of disability and higher recovery from disability yield a net reduction of the length of time spent with disability (at age 30: −0.9 years in men and −1.1 years in women) and increases the length of time lived without disability (2.5 and 1.9 years, for men and women, respectively). These outcomes indicate that elimination of smoking will extend life and the period of disability free life, and will compress disability into a shorter period.
CONCLUSIONS—Eliminating smoking will not only extend life and result in an increase in the number of years lived without disability, but will also compress disability into a shorter period. This implies that the commonly found trade off between longer life and a longer period with disability does not apply. Interventions to discourage smoking should receive high priority.


Keywords: smoking; morbidity

Full Text

The Full Text of this article is available as a PDF (209.1 KB).

Selected References

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

  1. Barendregt J. J., Bonneux L., van der Maas P. J. The health care costs of smoking. N Engl J Med. 1997 Oct 9;337(15):1052–1057. doi: 10.1056/NEJM199710093371506. [DOI] [PubMed] [Google Scholar]
  2. Boult C., Kane R. L., Louis T. A., Boult L., McCaffrey D. Chronic conditions that lead to functional limitation in the elderly. J Gerontol. 1994 Jan;49(1):M28–M36. doi: 10.1093/geronj/49.1.m28. [DOI] [PubMed] [Google Scholar]
  3. Branch L. G. Health practices and incident disability among the elderly. Am J Public Health. 1985 Dec;75(12):1436–1439. doi: 10.2105/ajph.75.12.1436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Doll R., Peto R., Wheatley K., Gray R., Sutherland I. Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994 Oct 8;309(6959):901–911. doi: 10.1136/bmj.309.6959.901. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Guccione A. A., Felson D. T., Anderson J. J., Anthony J. M., Zhang Y., Wilson P. W., Kelly-Hayes M., Wolf P. A., Kreger B. E., Kannel W. B. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health. 1994 Mar;84(3):351–358. doi: 10.2105/ajph.84.3.351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Guralnik J. M., Kaplan G. A. Predictors of healthy aging: prospective evidence from the Alameda County study. Am J Public Health. 1989 Jun;79(6):703–708. doi: 10.2105/ajph.79.6.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Keil J. E., Gazes P. C., Sutherland S. E., Rust P. F., Branch L. G., Tyroler H. A. Predictors of physical disability in elderly blacks and whites of the Charleston Heart Study. J Clin Epidemiol. 1989;42(6):521–529. doi: 10.1016/0895-4356(89)90148-0. [DOI] [PubMed] [Google Scholar]
  8. LaCroix A. Z., Guralnik J. M., Berkman L. F., Wallace R. B., Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol. 1993 Apr 15;137(8):858–869. doi: 10.1093/oxfordjournals.aje.a116747. [DOI] [PubMed] [Google Scholar]
  9. Mackenbach J. P., van de Mheen H., Stronks K. A prospective cohort study investigating the explanation of socio-economic inequalities in health in The Netherlands. Soc Sci Med. 1994 Jan;38(2):299–308. doi: 10.1016/0277-9536(94)90399-9. [DOI] [PubMed] [Google Scholar]
  10. Nusselder W. J., van der Velden K., van Sonsbeek J. L., Lenior M. E., van den Bos G. A. The elimination of selected chronic diseases in a population: the compression and expansion of morbidity. Am J Public Health. 1996 Feb;86(2):187–194. doi: 10.2105/ajph.86.2.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Rogers R. G., Powell-Griner E. Life expectancies of cigarette smokers and nonsmokers in the United States. Soc Sci Med. 1991;32(10):1151–1159. doi: 10.1016/0277-9536(91)90092-q. [DOI] [PubMed] [Google Scholar]
  12. Smith P. W., Roccaforte J. S., Daly P. B. Infection and immune response in the elderly. Ann Epidemiol. 1992 Nov;2(6):813–822. doi: 10.1016/1047-2797(92)90075-2. [DOI] [PubMed] [Google Scholar]
  13. Verbrugge L. M., Jette A. M. The disablement process. Soc Sci Med. 1994 Jan;38(1):1–14. doi: 10.1016/0277-9536(94)90294-1. [DOI] [PubMed] [Google Scholar]
  14. van de Mheen P. J., Gunning-Schepers L. J. Reported prevalences of former smokers in survey data: the importance of differential mortality and misclassification. Am J Epidemiol. 1994 Jul 1;140(1):52–57. doi: 10.1093/oxfordjournals.aje.a117158. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES