Abstract
The aim of this study was to determine the extent to which smokers and smoking quitters differ in habits and risk factors from non-smokers. Subjects comprised 8,109 patients aged 35–67 years having health checks in British primary care. We compared lifestyle and measured cardiovascular risk factors in smokers, former smokers and lifelong abstainers in cross-sectional analyses, and in prospective data in quitters. Results were adjusted for confounding factors. Considering 25 aspects of lifestyle, smokers had significantly worse habits in 20 compared to abstainers, and in 17 compared to former smokers. These included eating more white bread, full cream milk, fried food and meat, and less fruit and vegetables, wholemeal bread and bran cereals. Smokers report drinking more alcohol and taking less exercise. Smokers' mean serum levels were higher for total and low density lipoprotein cholesterol and triglycerides and lower for high density lipoprotein cholesterol. Within five years ex-smokers' data became comparable to lifelong abstainers for most factors, with apparent attenuation over up to 20 years for triglyceride, body mass index and scores for fibre and polyunsaturated fat intake. Smokers who quit after initial examinations had better health profiles even before quitting (p = 0.016) and subsequently made more beneficial health changes (p = 0.039) than continuing smokers. Smoking is associated with relatively poor health choices and risk factor levels. Stopping smoking is associated with a wide range of improved health markers beyond avoidance of tobacco toxicity.
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Contributor Information
Jinling Tang, Research Fellow, for the OXCHECK Study Group, Imperial Cancer Research Fund General Practice Research Group, Department of Public Health and Primary Care, University of Oxford Radcliffe Infirmary.
John Muir, Senior Research Fellow, for the OXCHECK Study Group, Imperial Cancer Research Fund General Practice Research Group, Department of Public Health and Primary Care, University of Oxford Radcliffe Infirmary.
Tim Lancaster, Research Fellow, for the OXCHECK Study Group, Imperial Cancer Research Fund General Practice Research Group, Department of Public Health and Primary Care, University of Oxford Radcliffe Infirmary.
Lesley Jones, Statistician, for the OXCHECK Study Group, Imperial Cancer Research Fund General Practice Research Group, Department of Public Health and Primary Care, University of Oxford Radcliffe Infirmary.
Godfrey Fowler, Professor, for the OXCHECK Study Group, Imperial Cancer Research Fund General Practice Research Group, Department of Public Health and Primary Care, University of Oxford Radcliffe Infirmary.