Association between smoking cessation and short-term health-care use: results from an international prospective cohort study (ATTEMPT)

Authors

  • Emma Beard,

    Corresponding author
    1. Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
    • Correspondence to: Emma Beard, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BP, UK. E-mail: e.beard@ucl.ac.uk

    Search for more papers by this author
  • Lion Shahab,

    1. Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
    Search for more papers by this author
  • Susan J. Curry,

    1. Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA
    Search for more papers by this author
  • Robert West

    1. Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
    Search for more papers by this author

  • [The copyright line for this article was changed on 15 July 2014 after original online publication.]

Abstract

Background and aims

Previous studies have found that smoking cessation is associated with a short-term increase in health-care use. This may be because ‘sicker’ smokers are more likely to stop smoking. The current study assessed the association between smoking cessation and health-care use, adjusting for pre-cessation physical and mental health conditions.

Design/setting

Data came from the ATTEMPT cohort, a multi-national prospective survey of smokers in the United States, Canada, United Kingdom, France and Spain, that lasted 18 months (with follow-ups every 3 months).

Participants

A total of 3645 smokers completed the baseline questionnaire. All participants smoked at least five cigarettes per day, intended to quit smoking within the next 3 months and were between 35 and 65 years of age.

Measurements

Participants were asked questions about their socio-demographic and smoking characteristics, as well previous smoking-related morbidities. Participants were also asked to report their health-care use in the previous 3 months i.e. emergency room (ER) visits, hospitalization, whether hospitalization required surgery, and health-care appointments.

Findings

A total of 8252, 4779 and 1954 baseline episodes of smoking were available for 3, 6 and 12 months, respectively. Of these, 2.8% (n = 230), 0.9% (n = 40) and 0.7% (n = 14) were followed by 3, 6 and 12 months of abstinence. No significant differences were found among 3, 6 or 12 months of abstinence and ER visits, hospitalization and whether hospitalization required surgery or health-care visits. However, 6-month smoking cessation episodes were associated with higher odds of reporting an appointment with a dietician.

Conclusion

Smoking cessation does not appear to be associated with a substantial short-term increase or decrease in health-care use after adjusting for pre-cessation morbidities.

Ancillary