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Combined health risks of cigarette smoking and low levels of physical activity: a prospective cohort study in England with 12-year follow-up

Jackson, SE; Brown, J; Ussher, M; Shahab, L; Steptoe, A; Smith, L (2019) Combined health risks of cigarette smoking and low levels of physical activity: a prospective cohort study in England with 12-year follow-up. BMJ Open, 9 (11). e032852. ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2019-032852
SGUL Authors: Ussher, Michael Henry

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Abstract

Objectives To (1) estimate the combined risks of cigarette smoking and physical inactivity for chronic disease, disability and depressive symptoms and (2) determine whether risks associated with these behaviours are additive or synergistic. Design and setting Longitudinal observational population study using data from Waves 2 (2004/2005) through 8 (2016/2017) of the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults in England. Participants 6425 men and women aged ≥52 years (mean (SD) 65.88 (9.34) years) at baseline. Main outcome measures Smoking status (never, former, current) and level of physical activity (high, defined as moderate/vigorous physical activity (MVPA) more than once a week; low, defined as MVPA once a week or less) were self-reported at Wave 2 baseline. Self-rated health, limiting long-standing illness, chronic conditions (coronary heart disease (CHD), stroke, cancer, chronic lung disease) and depressive symptoms were reported in each biennial wave. Results Both smoking and low levels of physical activity were associated with increased risk of incident health problems over the 12-year follow-up period. Current smokers with low levels of physical activity had especially high risks of developing fair/poor self-rated health, CHD, stroke, cancer and chronic lung disease compared with highly active never smokers (adjusted relative risk range 1.89–14.00). While additive effects were evident, tests of multiplicative interactions revealed no evidence of large synergistic effects of smoking and low physical activity (Bayes factor range 0.04–0.61), although data were insensitive to detect smaller effects. Conclusions Among older adults in England, there was no evidence of large synergistic effects of smoking and low levels of physical activity on risk of developing chronic disease or depressive symptoms over 12 years. However, additive effects of smoking and low levels of physical activity were evident, underscoring the importance of each of these lifestyle risk behaviours for disease onset.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Keywords: cancer, coronary heart disease, depression, lung disease, physical activity, self-rated health, smoking, stroke
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: BMJ Open
ISSN: 2044-6055
Language: eng
Dates:
DateEvent
27 November 2019Published
5 November 2019Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
C1417/A22962Cancer Research UKhttp://dx.doi.org/10.13039/501100000289
ES/R005990/1Economic and Social Research Councilhttp://dx.doi.org/10.13039/501100000269
PubMed ID: 31780593
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111400
Publisher's version: https://doi.org/10.1136/bmjopen-2019-032852

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