title: Pleasure or pain? A profile of smokers in Northern England.
abstract: OBJECTIVE
  To construct a profile of smokers using multiple indices of physical, mental and social health.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  The setting was Wigan and Bolton Health Authority, an urban district in the North West of England. A random sample of over 15000 adults from the Health Authority adult population completed a written questionnaire. Prevalence ratios were calculated for physical, mental and social health indicators for smokers compared with non-smokers, adjusted for borough, age and deprivation score of place of residence.
  
  
  RESULTS
  Smokers were less likely to report their current health as good, and reported a significantly higher prevalence of arthritis, bronchitis, backache and respiratory symptoms. Smokers had more mobility problems and recent severe pain. Smokers had less healthy lifestyles across many behaviours (e.g. poorer diet, taking less regular exercise and more problem drinking). Depression and the proportion of people with a high psychiatric morbidity score were increased. More women smokers reported a lack of social support, and smokers more often reported financial difficulties. Differences were exaggerated by comparing heavy smokers with non-smokers.
  
  
  CONCLUSIONS
  Independent of the level of deprivation of their area of residence, smokers have poorer physical, social and mental health, with a dose-response effect. Smoking creates considerable pain, but little evidence of pleasure.
authors.affiliation: Department of Public Health, Wellington School of Medicine and Health Sciences, University of Otago, PO Box 7343, Wellington, New Zealand. richard.edwards@otago.ac.nz
authors.forename: R
authors.initials: R
authors.lastname: Edwards
authors.forename: P
authors.initials: P
authors.lastname: McElduff
authors.forename: R A
authors.initials: RA
authors.lastname: Harrison
authors.forename: K
authors.initials: K
authors.lastname: Watson
authors.forename: G
authors.initials: G
authors.lastname: Butler
authors.forename: P
authors.initials: P
authors.lastname: Elton
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D015438:Health Behavior; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010146:Pain / Q000150:complications; D015995:Prevalence; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D012944:Social Support; D014505:Urban Population