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Results From the SAPALDIA Cohort Study 2

Pierre-Olivier Bridevaux, MD, MSc; Jacques Cornuz, MD, MPH; Jean-Michel Gaspoz, MD, MSc; Bernard Burnand, MD, MPH; Ursula Ackermann-Liebrich, MD; Christian Schindler, PhD; Philippe Leuenberger, MD; Thierry Rochat, MD; Margaret W. Gerbase, MD, PhD; for the SAPALDIA Team

Arch Intern Med. 2007;167(22):2516-2523.

Background  Although secondhand smoke (SHS) has been linked with various respiratory conditions and symptoms, its association with health-related quality of life (HRQOL) is unknown.

Methods  A cross-sectional study was performed of 2500 never smokers in Switzerland who participated in the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults and completed a 36-Item Short Form Health Survey (SF-36) in 2002. Using linear regression models adjusting for confounders, we measured the association between HRQOL and moderate or high SHS exposure (3 h/d or >3 h/d) compared with no SHS exposure. Data from men and women were analyzed separately and further stratified by source of SHS (home, workplace, and public spaces).

Results  After adjustments, SHS was associated with reduced scores in all SF-36 domains. High SHS exposure predicted a greater reduction in HRQOL. Compared with nonexposed women, those with high SHS exposure at home had significantly lower scores on the physical functioning (–7.8, P < .001), role physical (–10.5, P = .02), bodily pain (–9.2, P = .01), and social functioning (–8.1, P = .007) domains. Exposed men had lower scores for the role physical domain (–20.0, P < .001) and a trend toward lower scores in other domains. In women, exposure to SHS at home was associated with a stronger negative effect on HRQOL than at work and in public spaces.

Conclusions  Secondhand smoke is associated with reduced HRQOL, more significantly so in women. Exposure to SHS at home and high levels of exposure are associated with lower SF-36 scores, suggesting a dose-response relationship.

Author Affiliations: Institute of Social and Preventive Medicine (Drs Bridevaux, Cornuz, and Burnand) and Policlinique Médicale Universitaire (Dr Cornuz), University of Lausanne, Lausanne, Switzerland; Divisions of Primary Care Medicine (Dr Gaspoz) and Pulmonary Medicine (Drs Bridevaux, Rochat, and Gerbase), University Hospitals of Geneva, Geneva, Switzerland; Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland (Drs Ackermann-Liebrich and Schindler); and Division of Pulmonology, University Hospital Lausanne (Drs Bridevaux and Leuenberger).