title: Smoking and quality of life among female survivors of breast, colorectal and endometrial cancers in a prospective cohort study.
abstract: OBJECTIVE
  To examine the association of smoking and quality of life (QOL) among survivors of breast, colorectal, or endometrial cancers.
  
  
  METHODS
  The study included women who joined the Iowa Women's Health Study in 1986 and were subsequently diagnosed with breast, colorectal, or endometrial cancers through 2004 (n = 1920). Smoking status was reported at baseline and in 2004; QOL was assessed in 2004 using the Medical Outcomes Study Short Form-36. Multivariate-adjusted odds ratios were calculated to examine the associations of smoking status and poor QOL (score lower than one-half a standard deviation below the mean of the non-smokers).
  
  
  RESULTS
  Compared with non-smokers, persistent smokers had higher likelihood of reporting poor Physical Functioning (odds ratio [OR] = 2.40, 95% confidence interval [CI] = 1.32-4.37), Mental Health (OR = 1.92, CI = 1.09-3.40), and Role Emotional (OR = 2.01, CI = 1.10-3.66), whereas former smokers had higher likelihood of reporting poor Physical Functioning (OR = 1.65, CI = 1.10-2.45), Mental Health (OR = 1.62, CI = 1.11-2.37), and General Health (OR = 1.51, CI = 1.03-2.21). A statistically significant trend toward higher likelihood of poor QOL was observed across smoking groups in Vitality, Physical Functioning, Mental Health, and Role Emotional. Further adjustment for physical activity resulted in attenuation of the odds ratios and p-values for trend.
  
  
  CONCLUSIONS
  Among women with breast, colorectal, or endometrial cancers, smokers were more likely than former or non-smokers to have poor QOL. Physical activity explained, in part, the association between smoking status and QOL in our study.
authors.affiliation: Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, 55455, USA. jangx079@umn.edu
authors.forename: Sekwon
authors.initials: S
authors.lastname: Jang
authors.forename: Anna
authors.initials: A
authors.lastname: Prizment
authors.forename: Tufia
authors.initials: T
authors.lastname: Haddad
authors.forename: Kim
authors.initials: K
authors.lastname: Robien
authors.forename: Deann
authors.initials: D
authors.lastname: Lazovich
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000401:mortality / Q000523:psychology*; D016889:Endometrial Neoplasms / Q000401:mortality / Q000523:psychology*; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012907:Smoking / Q000523:psychology*; D017741:Survivors
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