The effects of smoking and physical inactivity on advancing mortality in U.S. adults

PurposeThe aim of the study was to calculate the rate advancement period (RAP) by which deaths for all-cause and cardiovascular disease (CVD)-specific mortality is advanced by smoking and physical inactivity among U.S. adults aged 18 years or more who participated in the Third National Health and Nutrition Examination Survey and were followed to December 31, 2006.MethodsMortality status was determined using the underlying cause of death. Cox regression was used to calculate the advanced time of deaths for all-cause and CVD-specific mortality among exposed adults relative to their nonexposed counterparts.ResultsDeaths for all-cause and CVD-specific mortality were advanced by 7.9 and 5.1 years among current smoker adults. For physically inactive adults, the RAPs for all-cause and CVD-specific mortality were 4.0 and 2.4 years, respectively. The joint effects of current smoking, physical inactivity, and obesity resulted in early all-cause and CVD-specific deaths of 14.2 and 12.2 years. For current smokers, physically inactive, and overweight adults, the RAPs for all-cause and CVD-specific deaths were 7.9 and 8.9 years, respectively.ConclusionsOur findings suggest that smoking and physical inactivity could significantly advance the time of death associated with all-cause and CVD-specific mortality by at least 2.4 years among U.S. adults. Moreover, the advancement death period for the joint effects of smoking, physical inactivity, and overweight or obesity could be at least 7.9 years.