{"title":"Self-Rated Health by Time Since Smoking Cessation","authors":"Yusuff Adebayo Adebisi BPharm, MSc , Najim Z. Alshahrani MBBS, MPH, MD , Isaac Olushola Ogunkola BSc , Nafisat Dasola Jimoh BTech","doi":"10.1016/j.amepre.2025.108040","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Although the physiologic benefits of quitting smoking are well established, less is known about how those who formerly smoked perceive these benefits over time. This study investigates the association between time since smoking cessation and self-rated health in a nationally representative sample and examines how predicted self-rated health varies by age, area-level deprivation, and education.</div></div><div><h3>Methods</h3><div>Data were drawn from the 2017, 2018, 2019, and 2021 waves of the Scottish Health Survey, yielding a sample of 5,701 adults aged ≥16 years who had formerly smoked. The primary outcome was self-rated health, grouped as very good/good, fair, or bad/very bad. The main exposure was time since quitting smoking, categorized as <2 years, 2 to <5 years, 5 to <10 years, 10 to <20 years, and ≥20 years. Generalized ordered logistic regression was used to estimate crude and AORs for self-rated health. Predictive margins were calculated to assess variation across sociodemographic subgroups. All analyses were conducted in 2025.</div></div><div><h3>Results</h3><div>Longer cessation duration was associated with significantly lower odds of reporting poorer self-rated health. Compared with those who had quit within the past 2 years, AORs were 0.81 (95% CI=0.62, 1.06; <em>p</em>=0.125) for those aged 2 to <5 years, 0.75 (95% CI=0.58, 0.97; <em>p</em>=0.027) for those aged 5 to <10 years, 0.63 (95% CI=0.49, 0.80; <em>p</em><0.001) for those aged 10 to <20 years, and 0.45 (95% CI=0.36, 0.58; <em>p</em><0.001) for those aged ≥20 years. When modeled as a continuous ordinal variable, each additional cessation category was associated with lower odds of poorer self-rated health (AOR=0.82; 95% CI=0.78, 0.87; <em>p</em><0.001). Predicted probabilities of reporting good or very good health increased with time since quitting across all subgroups (<em>p</em><0.001). Among adults aged 45–64 years, probabilities rose from 59.7% (95% CI=53.6%, 65.9%) for those aged <2 years to 72.2% (95% CI=69.4%, 74.9%) for those aged ≥20 years. Among those in the least deprived areas, the increase was from 64.4% (95% CI=54.0%, 74.8%) to 76.3% (95% CI=73.2%, 79.5%), and among individuals with higher education, it was from 65.7% (95% CI=58.1%, 73.4%) to 79.1% (95% CI=76.6%, 81.6%).</div></div><div><h3>Conclusions</h3><div>Longer time since smoking cessation is associated with more favorable self-rated health, suggesting a graded, perceived benefit over time. However, these perceived subjective health gains are not evenly distributed because individuals in disadvantaged groups continue to report lower probabilities of good health even after long-term cessation.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108040"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0749379725005161","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Although the physiologic benefits of quitting smoking are well established, less is known about how those who formerly smoked perceive these benefits over time. This study investigates the association between time since smoking cessation and self-rated health in a nationally representative sample and examines how predicted self-rated health varies by age, area-level deprivation, and education.
Methods
Data were drawn from the 2017, 2018, 2019, and 2021 waves of the Scottish Health Survey, yielding a sample of 5,701 adults aged ≥16 years who had formerly smoked. The primary outcome was self-rated health, grouped as very good/good, fair, or bad/very bad. The main exposure was time since quitting smoking, categorized as <2 years, 2 to <5 years, 5 to <10 years, 10 to <20 years, and ≥20 years. Generalized ordered logistic regression was used to estimate crude and AORs for self-rated health. Predictive margins were calculated to assess variation across sociodemographic subgroups. All analyses were conducted in 2025.
Results
Longer cessation duration was associated with significantly lower odds of reporting poorer self-rated health. Compared with those who had quit within the past 2 years, AORs were 0.81 (95% CI=0.62, 1.06; p=0.125) for those aged 2 to <5 years, 0.75 (95% CI=0.58, 0.97; p=0.027) for those aged 5 to <10 years, 0.63 (95% CI=0.49, 0.80; p<0.001) for those aged 10 to <20 years, and 0.45 (95% CI=0.36, 0.58; p<0.001) for those aged ≥20 years. When modeled as a continuous ordinal variable, each additional cessation category was associated with lower odds of poorer self-rated health (AOR=0.82; 95% CI=0.78, 0.87; p<0.001). Predicted probabilities of reporting good or very good health increased with time since quitting across all subgroups (p<0.001). Among adults aged 45–64 years, probabilities rose from 59.7% (95% CI=53.6%, 65.9%) for those aged <2 years to 72.2% (95% CI=69.4%, 74.9%) for those aged ≥20 years. Among those in the least deprived areas, the increase was from 64.4% (95% CI=54.0%, 74.8%) to 76.3% (95% CI=73.2%, 79.5%), and among individuals with higher education, it was from 65.7% (95% CI=58.1%, 73.4%) to 79.1% (95% CI=76.6%, 81.6%).
Conclusions
Longer time since smoking cessation is associated with more favorable self-rated health, suggesting a graded, perceived benefit over time. However, these perceived subjective health gains are not evenly distributed because individuals in disadvantaged groups continue to report lower probabilities of good health even after long-term cessation.
期刊介绍:
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.