期刊论文详细信息
BMC Public Health
Smoking and health-related quality of life in English general population: implications for economic evaluations
Subhash Pokhrel2  Reiner Leidl1  Christina M Wenig1  Matthias Vogl1 
[1] Ludwig-Maximilians-Universität München, Institute of Health Economics and Health Care Management & Munich Centre of Health Sciences, Ludwigstrasse 28, 80539 Munich, Germany;Health Economics Research Group, Brunel University, West London, UK
关键词: Economic evaluation;    Socio-economic determinant;    EuroQol;    EQ-5D;    Health-related quality of life (HRQoL);   
Others  :  1163772
DOI  :  10.1186/1471-2458-12-203
 received in 2011-10-13, accepted in 2012-03-19,  发布年份 2012
PDF
【 摘 要 】

Background

Little is known as to how health-related quality of life (HRQoL) when measured by generic instruments such as EQ-5D differ across smokers, ex-smokers and never-smokers in the general population; whether the overall pattern of this difference remain consistent in each domain of HRQoL; and what implications this variation, if any, would have for economic evaluations of tobacco control interventions.

Methods

Using the 2006 round of Health Survey for England data (n = 13,241), this paper aims to examine the impact of smoking status on health-related quality of life in English population. Depending upon the nature of the EQ-5D data (i.e. tariff or domains), linear or logistic regression models were fitted to control for biology, clinical conditions, socio-economic background and lifestyle factors that an individual may have regardless of their smoking status. Age- and gender-specific predicted values according to smoking status are offered as the potential 'utility' values to be used in future economic evaluation models.

Results

The observed difference of 0.1100 in EQ-5D scores between never-smokers (0.8839) and heavy-smokers (0.7739) reduced to 0.0516 after adjusting for biological, clinical, lifestyle and socioeconomic conditions. Heavy-smokers, when compared with never-smokers, were significantly more likely to report some/severe problems in all five domains - mobility (67%), self-care (70%), usual activity (42%), pain/discomfort (46%) and anxiety/depression (86%) -. 'Utility' values by age and gender for each category of smoking are provided to be used in the future economic evaluations.

Conclusion

Smoking is significantly and negatively associated with health-related quality of life in English general population and the magnitude of this association is determined by the number of cigarettes smoked. The varying degree of this association, captured through instruments such as EQ-5D, may need to be fed into the design of future economic evaluations where the intervention being evaluated affects (e.g. tobacco control) or is affected (e.g. treatment for lung cancer) by individual's (or patients') smoking status.

【 授权许可】

   
2012 Vogl et al; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150413114338470.pdf 265KB PDF download
【 参考文献 】
  • [1]WHO: World Health Organisation, Tobacco, fact sheet N°339. [http://www.who.int/mediacentre/factsheets/fs339/en/index.html] webcite
  • [2]Allender S, Balakrishnan R, Scarborough P, Webster P, Rayner M: The burden of smoking-related ill health in the UK. Tob Control 2009, 18(4):262-267.
  • [3]Neubauer S, Welte R, Beiche A, Koenig HH, Buesch K, Leidl R: Mortality, morbidity and costs attributable to smoking in Germany: update and a 10-year comparison. Tob Control 2006, 15(6):464-471.
  • [4]Marmot M: Fair Society, Healthy Lives. [http:/ / www.instituteofhealthequity.org/ projects/ fair-society-healthy-lives-the-marm ot-review] webcite
  • [5]WHO: The World Health Report 2008. [http://www.who.int/whr/2008/whr08_en.pdf] webcite
  • [6]Health Development Agency NHS: Smoking epidemic in England. [http:/ / www.nice.org.uk/ aboutnice/ whoweare/ aboutthehda/ hdapublications/ hda_publications.jsp?o=609] webcite
  • [7]HM Government: A smokefree future: a comprehensive tobacco control strategy for England. [http:/ / www.dh.gov.uk/ en/ Publicationsandstatistics/ Publications/ PublicationsPolicyAndGuidance/ DH_111749] webcite
  • [8]The Stationery Office: Smoking Kills - A White Paper on Tobacco. [http://www.archive.official-documents.co.uk/document/cm41/4177/4177.htm] webcite
  • [9]NICE: Smoking cessation services in primary care, pharmacies, local authorities and workplaces, particularly for manual working groups, pregnant women and hard to reach communities (PH10). [http://guidance.nice.org.uk/PH10] webcite
  • [10]Coleman T, Agboola S, Leonardi-Bee J, Taylor M, McEwen A, McNeill A: Relapse prevention in UK Stop Smoking Services: current practice, systematic reviews of effectiveness and cost-effectiveness analysis. Health Technol Assess 2010, 14(49):1-152. iii-iv
  • [11]Tillmann M, Silcock J: A comparison of smokers' and ex-smokers' health-related quality of life. J Public Health Med 1997, 19(3):268-273.
  • [12]WHO: The European Tobacco Control Report 2007. [http://www.euro.who.int/__data/assets/pdf_file/0005/68117/E89842.pdf] webcite
  • [13]NICE: Guide to the methods of technology appraisal. [http://www.nice.org.uk/media/B52/A7/TAMethodsGuideUpdatedJune2008.pdf] webcite
  • [14]The EuroQol Group: EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 1990, 16(3):199-208.
  • [15]National Centre for Social Research and University College London. Department of Epidemiology and Public Health, Health Survey for England, 2006 [computer file] [http://dx.doi.org/test.] webcite 4th edition. Colchester, Essex: UK Data Archive [distributor]; 2011. SN: 5809
  • [16]NHS: HSE 2006 Cardiovascular disease and risk factors in adults. [http:/ / www.ic.nhs.uk/ webfiles/ publications/ HSE06/ HSE%2006%20report%20VOL%201%20v2.pd f] webcite
  • [17]Leidl R: Preferences, quality of life and public health. Eur J Public Health 2009, 19(3):228-229.
  • [18]Dolan P: Modeling valuations for EuroQol health states. Med Care 1997, 35(11):1095-1108.
  • [19]Konig HH, Bernert S, Angermeyer MC, Matschinger H, Martinez M, Vilagut G, Haro JM, de Girolamo G, de Graaf R, Kovess V, et al.: Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire. Med Care 2009, 47(2):255-261.
  • [20]Pickard AS, Wilke C, Jung E, Patel S, Stavem K, Lee TA: Use of a preference-based measure of health (EQ-5D) in COPD and asthma. Respir Med 2008, 102(4):519-536.
  • [21]Pickard AS, Wilke CT, Lin HW, Lloyd A: Health utilities using the EQ-5D in studies of cancer. Pharmacoeconomics 2007, 25(5):365-384.
  • [22]Schweikert B, Hahmann H, Leidl R: Validation of the EuroQol questionnaire in cardiac rehabilitation. Heart 2006, 92(1):62-67.
  • [23]Schweikert B, Hunger M, Meisinger C, Konig HH, Gapp O, Holle R: Quality of life several years after myocardial infarction: comparing the MONICA/KORA registry to the general population. Eur Heart J 2008, 30(4):436-443.
  • [24]Alava MH, Wailoo AJ, Ara R: HEDS Discussion Paper 10/08. [http://www.sheffield.ac.uk/polopoly_fs/1.43401!/file/HEDS-DP-10-08.pdf] webcite
  • [25]Brazier JE, Yang Y, Tsuchiya A, Rowen DL: A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures. Eur J Health Econ 2010, 11(2):215-225.
  • [26]Huang IC, Frangakis C, Atkinson MJ, Willke RJ, Leite WL, Vogel WB, Wu AW: Addressing Ceiling Effects in Health Status Measures: A Comparison of Techniques Applied to Measures for People with HIV Disease. Health Serv Res 2007, 43(1p1):327-339.
  • [27]Li L, Fu AZ: Some methodological issues with the analysis of preference-based EQ-5D index score. Health Serv Outcomes Res Methods 2009, 9(3):162-176.
  • [28]Sullivan PW, Ghushchyan VH: Can utilities exceed 1.0? Empirical evidence of the ceiling effect. Value Health 2011, 14(3):A148-A149.
  • [29]Austin PC, Escobar M, Kopec JA: The use of the Tobit model for analyzing measures of health status. Qual Life Res 2000, 9(8):901-910.
  • [30]Petrou S, Kupek E: Social capital and its relationship with measures of health status: evidence from the Health Survey for England 2003. Health Econ 2008, 17(1):127-143.
  • [31]Søltoft F, Hammer M, Kragh N: The association of body mass index and health-related quality of life in the general population: data from the 2003 Health Survey of England. Qual Life Res 2009, 18(10):1293-1299.
  • [32]Greene WH: Econometric Analysi. 5th edition. New Jersey: Prentice Hall; 2003.
  • [33]Heyworth ITM, Hazell ML, Linehan MF, Frank TL: How do common chronic conditions affect health-related quality of life? Br J Gen Pract 2009, 59(568):353-358.
  • [34]Pullenayegum EM, Tarride JE, Xie F, Goeree R, Gerstein HC, O'Reilly D: Analysis of health utility data when some subjects attain the upper bound of 1: are Tobit and CLAD models appropriate? Value Health 2010, 13(4):487-494.
  • [35]Pullenayegum EM, Tarride JE, Xie F, O'Reilly D: Calculating Utility Decrements Associated With an Adverse Event: Marginal Tobit and CLAD Coefficients Should Be Used With Caution. Med Decis Making 2011, in press. doi: 10.1177/0272989X10393284
  • [36]Leidl R, Reitmeir P: A Value Set for the EQ-5D Based on Experienced Health States: Development and Testing for the German Population. Pharmacoeconomics 2011, 29(6):521-534.
  • [37]Hunger M, Baumert J, Holle R: Analysis of SF-6D Index Data: Is Beta Regression Appropriate? Value in Health 2011, in press.
  • [38]Austin PC: A comparison of methods for analyzing health-related quality-of-life measures. Value Health 2002, 5(4):329-337.
  • [39]Misajon R, Pallant JF, Manderson L, Chirawatkul S: Measuring the impact of health problems among adults with limited mobility in Thailand: further validation of the Perceived Impact of Problem Profile. Health Qual Life Outcomes 2008, 6(1):6. BioMed Central Full Text
  • [40]Hunger M, Thorand B, Schunk M, Doring A, Menn P, Peters A, Holle R: Multimorbidity and health-related quality of life in the older population: results from the German KORA-Age study. Health and Quality of Life Outcomes 2011., 9(53) doi:10.1186/1477-7525-9-53
  • [41]Hosmer DW, Lemeshow S: Applied Logistic Regression. New York: Wiley; 2000.
  • [42]Davies HT, Crombie IK, Tavakoli M: When can odds ratios mislead? BMJ 1998, 316(7136):989-991.
  • [43]Briggs A, Claxton K, Sculpher M: Decision Modelling for Health Economic Evaluatio. Oxford: Oxford University Press; 2006.
  • [44]Stollenwerk B, Stock S, Siebert U, Lauterbach KW, Holle R: Uncertainty Assessment of Input Parameters for Economic Evaluation: Gauss's Error Propagation, an Alternative to Established Methods. Med Decis Making 2010, 30(3):304-313.
  • [45]Kind P, Dolan P, Gudex C, Williams A: Variations in population health status: results from a United Kingdom national questionnaire survey. BMJ 1998, 316(7133):736-741.
  • [46]Jia H, Lubetkin EI: Trends in Quality-Adjusted Life-Years Lost Contributed by Smoking and Obesity. Am J Prev Med 2010, 38(2):138-144.
  • [47]Bryan S, Longworth L: Measuring health-related utility: why the disparity between EQ-5D and SF-6D? Eur J Health Econ 2005, 6(3):253-260.
  • [48]Le QA, Doctor JN: Probabilistic mapping of descriptive health status responses onto health state utilities using Bayesian networks: an empirical analysis converting SF-12 into EQ-5D utility index in a national US sample. Med Care 2011, 49(5):451-460.
  • [49]Guiterrez-Bedmar M, Segui-Gomez M, Gomez-Gracia E, Bes-Rastrollo M, Martinez-Gonzalez MA: Smoking status, changes in smoking status and health-related quality of life: findings from the SUN ("Seguimiento Universidad de Navarra") cohort. Int J Environ Res Public Health 2009, 6(1):310-320.
  • [50]Laaksonen M, Rahkonen O, Martikainen P, Karvonen S, Lahelma E: Smoking and SF-36 health functioning. Prev Med 2006, 42(3):206-209.
  • [51]Wilson D, Parsons J, Wakefield M: The health-related quality-of-life of never smokers, ex-smokers, and light, moderate, and heavy smokers. Prev Med 1999, 29(3):139-144.
  • [52]Mulder I, Tijhuis M, Smit HA, Kromhout D: Smoking cessation and quality of life: the effect of amount of smoking and time since quitting. Prev Med 2001, 33(6):653-660.
  • [53]Strine TW, Okoro CA, Chapman DP, Balluz LS, Ford ES, Ajani UA, Mokdad AH: Health-related quality of life and health risk behaviors among smokers. Am J Prev Med 2005, 28(2):182-187.
  • [54]Bronnum-Hansen H, Juel K, Davidsen M, Sorensen J: Impact of selected risk factors on quality-adjusted life expectancy in Denmark. Scand J Public Health 2007, 35(5):510-515.
  • [55]Lyons RA, Lo SV, Littlepage BNC: Perception of health amongst ever-smokers and never-smokers: a comparison using the SF-36 Health Survey Questionnaire. Tob Control 1994, 3(3):213-215.
  • [56]Office for National Statistics: General LiFestlye Survey (GLF). [http:/ / www.ons.gov.uk/ ons/ guide-method/ surveys/ respondents/ household/ general-lifestyle-survey/ index.html] webcite
  • [57]Wilson A: Smoking cessation treatment in primary care: prospective cohort study. Tob Control 2005, 14(4):242-246.
  • [58]Hayase T: Chronologically overlapping occurrences of nicotine-induced anxiety-and depression-related behavioral symptoms: effects of anxiolytic and cannabinoid drugs. BMC Neurosci 2007, 8:76. BioMed Central Full Text
  • [59]West R, Hajek P: What happens to anxiety levels on giving up smoking? Am J Psychiatry 1997, 154(11):1589-1592.
  • [60]Bellido-Casado J, Martin-Escudero J, Duenas-Laita A, Mena-Martin FJ, Arzua-Mouronte D, Simal-Blanco F: The SF-36 Questionnaire as a measurement of health-related quality of life: assessing short- and medium-term effects of exposure to tobacco versus the known long-term effects. Eur J Intern Med 2004, 15(8):511-517.
  • [61]Mody RR, Smith MJ: Smoking status and health-related quality of life: as findings from the 2001 Behavioral Risk Factor Surveillance System data. Am J Health Promot 2006, 20(4):251-258.
  • [62]McClave AK, Dube SR, Strine TW, Mokdad AH: Associations between health-related quality of life and smoking status among a large sample of U.S. adults. Prev Med 2009, 48(2):173-179.
  • [63]Funahashi K, Takahashi I, Danjo K, Matsuzaka M, Umeda T, Nakaji S: Smoking habits and health-related quality of life in a rural Japanese population. Qual Life Res 2010, 20(2):199-204.
  • [64]Haacke C: Long-Term Outcome After Stroke: Evaluating Health-Related Quality of Life Using Utility Measurements. Stroke 2005, 37(1):193-198.
  • [65]Iglesias CP, Manca A, Torgerson DJ: The health-related quality of life and cost implications of falls in elderly women. Osteoporos Int 2008, 20(6):869-878.
  • [66]Jia H, Lubetkin EI: The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health 2005, 27(2):156-164.
  • [67]Wang H-M, Beyer M, Gensichen J, Gerlach FM: Health-related quality of life among general practice patients with differing chronic diseases in Germany: Cross sectional survey. BMC Public Health 2008, 8(1):246. BioMed Central Full Text
  • [68]Sendi P, Brunotte R, Potoczna N, Branson R, Horber FF: Health-related quality of life in patients with class II and class III obesity. Obes Surg 2005, 15(7):1070-1076.
  • [69]Rutten-van Molken MPMH, Oostenbrink JB, Tashkin DP, Burkhart D, Monz BU: Does Quality of Life of COPD Patients as Measured by the Generic EuroQol Five-Dimension Questionnaire Differentiate Between COPD Severity Stages? Chest 2006, 130(4):1117-1128.
  文献评价指标  
  下载次数:4次 浏览次数:9次