Smoking and health-related quality of life among U.S. Adolescents

Smoking continues to be a public health problem among youth. Developmentally, adolescence is a period marked by the vulnerability to initiate risk behaviors such as smoking. While studies have documented associations between smoking and poor health related quality of life (HRQOL) among adults, little is known about the association among adolescents.

Data on smoking and HRQOL from a sample of 4,848 adolescents aged 12-17 years from the 2001-2008 National Health and Nutrition Examination Surveys were analyzed. Smoking status (current, not current, and never) was determined using self-report data and serum cotinine levels. HRQOL was assessed based on self-reported physical and mental health in the last 30 days, activity limitations in the last 30 days, and general self-rated health.

Compared with never smokers, adolescents who ever smoked reported more recent physically unhealthy days (p < .001), mentally unhealthy days (p < .0001), and activity limitation days (p < .01). Compared with never smokers, adolescents who ever smoked or who were current smokers were more likely to report ≥ 14 physically unhealthy days, ≥ 14 mentally unhealthy, ≥ 14 activity limitation days, and fair or poor health; not current smokers were also more likely than never smokers to report ≥ 14 days for being both physically unhealthy and mentally unhealthy.

Among a nationally representative sample of adolescents, this study found strong associations between smoking and HRQOL measures. The relationship of smoking to self-reported activity limitations warrants attention and further research. The findings underscore the importance of addressing smoking and subjective well-being early in the lifespan.