title: The earlier the better: health-related quality of life is inversely related to age of smoking cessation in older former Italian smokers.
abstract: BACKGROUND
  Quitting smoking has several health benefits, including an improvement in health-related quality of life. It is not well established if there is a relationship between the age when people stop smoking and health-related quality of life in older adults.
  
  
  OBJECTIVE
  The primary aim was to investigate the relationship between health-related quality of life and the age when people quit smoking in a national representative sample of community-dwelling older Italian adults. The secondary aim was to describe the characteristics of older former smokers according to their age when they stopped smoking.
  
  
  METHODS
  Data were drawn from the "Health and use of health care in Italy", a national cross-sectional survey (2004-2005). Seven thousand five hundred and sixty-two former smokers, aged 65 years and older, were evaluated by age of smoking cessation. Socio-demographic characteristics, physical activity, the 12-Item Short-Form Health Survey (SF-12) score and its physical (PCS-12) and mental (MCS-12) component summary scores, disability and comorbidities were analyzed.
  
  
  RESULTS
  Educational level, marital status and area of residence were associated with a different age of smoking cessation, as a higher level of disability and comorbidity. PCS-12 (β -0.144; p < 0.001) and MCS-12 (β -0.077; p < 0.001) component scores were lower in subjects who quit smoking later. The relationship was confirmed for the PCS-12 score even after adjustment for socio-demographic, disability and clinical variables (β -0.031; p < 0.001), while it disappeared for the MCS-12 score (β -0.010, p = 0.307), after adjustment for comorbidities.
  
  
  CONCLUSIONS
  Physical and mental health-related quality of life is influenced by the age of smoking cessation in older individuals, but this relationship is influenced by comorbidities, particularly depression. Some individual characteristics are related to the age of the person when he/she quit smoking.
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy. b.gasperini@univpm.it.
authors.forename: Beatrice
authors.identifier: http://orcid.org/0000-0002-9981-3460
authors.initials: B
authors.lastname: Gasperini
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Barbadoro
authors.affiliation: Geriatrics and Geriatrics Emergency Care, Italian National Research Center on Aging (IRCCS-INRCA), Ancona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.affiliation: Department of Economy, Section of Statistics, University of Perugia, Perugia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pierri
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Marcello M
authors.initials: MM
authors.lastname: D'Errico
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Stanislao
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Ponzio
authors.affiliation: Department of Biomedical Sciences and Public Health, Section of Hygiene, Preventive Medicine and Public Health, Polytechnic University of Marche, Piazza Roma, 22, 60121, Ancona, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Prospero
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011788:Quality of Life; D057566:Self Report; D016540:Smoking Cessation / Q000523:psychology*
keywords: Elderly; Quality of life; Quit smoking; Smoking