Numerous studies have shown that smokers have less healthy behaviours than ex or non- smokers. Thus, regular smokers eat fewer fruits and vegetables and tend to skip breakfast. On the other hand, ex and non-smokers drink less alcohol, exercise more, feel better about their health and have fewer chronic diseases.

However, ex-smokers require more medical care than nonsmokers. It is possible that smoking cessation duration influences health-related behaviours in ex-smokers. Since this has never been investigated, a team of Thai researchers has analysed the relationship between the duration of smoking cessation and health-related behaviours.

Almost 20,000 subjects analyzed

The authors used a sample from the fourth National Health Examination Surveys (NHES) that are conducted in Thailand every five years. The NHES IV study was conducted between 2008 and 2009 and included 19,371 subjects from 15 to 98 years of age. Their diet was analysed using a frequency questionnaire, as well as meal composition, the eventual use of dietary supplements, alcohol consumption, physical activity, smoking history and any tobacco-related diseases.

Subjects were divided into four age groups (15-30 years, 31-45 years, 46-60 years, over 60 years). They were further divided into “non-smokers”, “ex-smokers” (arbitrarily separated into three groups according to the duration of smoking cessation: less than one year, 1 to 10 years and more than 10 years) and “regular smokers”.

More fruits and breakfast in ex-smokers for over 10 years

In this Thai population, the prevalence of “regular”, ex” and “nonsmokers” were 22.3% (42.3% (men) vs. 4.3% (women)), 12% and 67.7%, respectively. Approximately 60% of the current smokers had attempted to quit and failed. The study showed that 96.6% of smokers who succeeded in their withdrawal did so without any medication or medical advice.

Regardless of their smoking status, at least 50% of all subjects ate more than three servings of vegetables, legumes and meat daily. Less than one-third ate more than two servings of fruit daily. The consumption of dairy products, soy drinks and whole grain cereals was low, particularly in smokers and ex smokers.

However, there was a continuous and statistically significant trend in favour of fruits, dairy products, soy drinks, whole grains, dietary supplements, breakfast and regularly three meals per day in non smokers and ex-smokers for over 10 years.

A clear relationship between the duration of smoking cessation and health-related behaviours

This study, in accordance with other investigations, confirms that ex-smokers have better health-related behaviours than smokers. Our study has revealed a relationship between the duration of smoking cessation and the consumption of fruits, legumes, meat, dairy products, soy drinks and whole grain cereals. Minimal differences were observed for vegetables. This could be explained by the fact that in Thailand, vegetables are already integrated into daily culinary habits; they are not expensive and easily available. Finally, the lower alcohol consumption in non smokers versus smokers reflects the close relationships between alcohol and tobacco consumption.

This study is one of the first to explore the relationships between the duration of smoking cessation and the evolution of healthrelated behaviours: longer smoking cessation (> 10 years) is associated with improved health-related behaviours in exsmokers.