Associations Between Smoking Status and Physical and Mental Health-Related Quality of Life Among Individuals With Mobility Impairments

Abstract

Background: In the general population, quitting smoking is associated with improved health-related quality of life (QoL), but this association has not been examined in smokers with chronic mobility impairments (MIs). Purpose: We examined associations between smoking status and health-related QoL over 6 months, and whether relationships are moderated by depression and MI severity. Methods: This is a secondary analysis of a smoking cessation induction trial among smokers with MIs (n = 241, 56% female, 36% Black) assessed at baseline, and 4 and 6 months after. Participants were grouped into "Smokers"(smoking at 4 and 6 months), "Abstainers"(quit at 4 and 6 months), "Relapsers"(relapsed at 6 months), and "Late-quitters"(quit at 6 months). Physical and mental health-related QoL was assessed with the Short-Form Health Survey. Depression was defined as scores ≥10 on the Patient Health Questionnaire, and MI severity by the use of skilled care for personal needs. Data were analyzed with linear mixed models. Results: Aggregating across time, among nondepressed participants, compared with "Smokers,"the "Abstainer,"and "Late-quitter"groups improved their physical health scores. "Late-quitters"also improved compared with "Relapsers."Among the total sample, compared with "Smokers,""Abstainers"showed improvements in mental health scores overtime, whereas "Relapsers"improved their score at 4 months, and "Late-quitters"improved at 6 months. Conclusions: Quitting smoking is associated with improvements in physical health-related QoL regardless of the severity of MI but only among those without depression at baseline. For mental health-related QoL, associations with quitting smoking were independent of baseline depression and severity of MI.