The effect of smoking on years of healthy life (YHL) lost among middle-aged and older Americans

Health Serv Res. 2004 Jun;39(3):531-52. doi: 10.1111/j.1475-6773.2004.00243.x.


Objective: To estimate the effects of smoking on quality of life over time, using the Years of Healthy Life (YHL) construct.

Data sources/study setting: The Health and Retirement Study (HRS) survey (N=12,652) of persons 50 to 60 years old and the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey (N=8,124) of persons > or =70 years old, plus spouses regardless of age, followed from 1992/1993 to 2000.

Study design: Years of healthy life from baseline to death were estimated. Regression models were developed with smoking as the main explanatory variable and with both YHL and years of life remaining as the outcome variables.

Principal findings: Smoking was strongly and consistently related to YHL lost. In HRS, individuals who had quit smoking at least 15 years prior to baseline had a similar number of YHL left as never smokers.

Conclusions: Efforts to encourage smoking cessation should emphasize the impact of these factors on quality of life.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Female
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Quality of Life*
  • Quality-Adjusted Life Years*
  • Regression Analysis
  • Sex Distribution
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Smoking Cessation
  • United States / epidemiology