Observational studyBMJ open2019
Combined health risks of cigarette smoking and low levels of physical activity: a prospective cohort study in England with 12-year follow-up.
Observational study in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Associations of cannabis use, tobacco use, and incident anxiety, mood, and psychotic disorders: a systematic review and meta-analysis.Psychological medicine · 2024Pooled it
- Trial
- Heated Tobacco Product Use and Lower Physical Activity Among Japanese Adults With and Without Respiratory Diseases: Findings From the JACSIS Study.Respirology (Carlton, Vic.) · 2026Article
- Association of combined healthy lifestyle factors with the risk of metabolic dysfunction-associated steatotic liver disease: the Korean National Health and Nutrition Examination Survey 2016-2021.BMC public health · 2026Article
- Estimating the hospitalisation burden of obesity in Europe: evidence from the European health interview survey (EHIS) wave 3.BMC public health · 2026Article
- Prevalence and Associated Factors of Physical Inactivity Among Malaysian Adults.Healthcare (Basel, Switzerland) · 2025Article
- The association of modifiable and socio-demographic factors with first transitions from smoking to exclusive e-cigarette use, dual use or no nicotine use: Findings from the Avon Longitudinal Study of Parents and Children United Kingdom birth cohort.Addiction (Abingdon, England) · 2025Article
- Article
- Effects of electronic smoking on daytime plasma cortisol levels and the possible ameliorating role of physical activity: a cross-sectional study.Journal of Yeungnam medical science · 2025Article
- Article
- Determinants of exercise adherence in sedentary middle-aged and older adults.Psychophysiology · 2024Article
- Association between movement behavior patterns and cardiovascular risk among Chinese adults aged 40-75: a sex-specific latent class analysis.BMC public health · 2024Article
- Physical activity and tobacco smoking in the German adult population.BMJ open sport & exercise medicine · 2024Article
- Associations between Health-Related Use of Social Media and Positive Lifestyle Behaviors: Findings from a Representative Sample of US Adult Smokers.Substance use & misuse · 2024Article
- The association between different types of physical activity and smoking behavior.BMC psychiatry · 2023Article
- Characterization of trajectories of physical activity and cigarette smoking from early adolescence to adulthood.BMC public health · 2023Article
- Associations of dual use of tobacco cigarettes and e-cigarettes, sleep duration, physical activity and depressive symptoms among middle-aged and older Korean adults.Nursing open · 2023Article
- Does Physical Activity Reduce the Risk of Perceived Negative Health in the Smoking Population?International journal of environmental research and public health · 2022Article
- Grip Strength Trajectories and Cognition in English and Chilean Older Adults: A Cross-Cohort Study.Journal of personalized medicine · 2022Article
- Five-Repetition Sit-to-Stand Test Performance in Healthy Individuals: Reference Values and Predictors From 2 Prospective Cohorts.Neurospine · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo (1) estimate the combined risks of cigarette smoking and physical inactivity for chronic disease, disability and depressive symptoms and (2) determine whether risks associated with these behaviours are additive or synergistic. DESIGN AND
settingLongitudinal observational population study using data from Waves 2 (2004/2005) through 8 (2016/2017) of the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults in England.
participants6425 men and women aged ≥52 years (mean (SD) 65.88 (9.34) years) at baseline.
main outcome measuresSmoking status (never, former, current) and level of physical activity (high, defined as moderate/vigorous physical activity (MVPA) more than once a week; low, defined as MVPA once a week or less) were self-reported at Wave 2 baseline. Self-rated health, limiting long-standing illness, chronic conditions (coronary heart disease (CHD), stroke, cancer, chronic lung disease) and depressive symptoms were reported in each biennial wave.
resultsBoth smoking and low levels of physical activity were associated with increased risk of incident health problems over the 12-year follow-up period. Current smokers with low levels of physical activity had especially high risks of developing fair/poor self-rated health, CHD, stroke, cancer and chronic lung disease compared with highly active never smokers (adjusted relative risk range 1.89-14.00). While additive effects were evident, tests of multiplicative interactions revealed no evidence of large synergistic effects of smoking and low physical activity (Bayes factor range 0.04-0.61), although data were insensitive to detect smaller effects.
conclusionsAmong older adults in England, there was no evidence of large synergistic effects of smoking and low levels of physical activity on risk of developing chronic disease or depressive symptoms over 12 years. However, additive effects of smoking and low levels of physical activity were evident, underscoring the importance of each of these lifestyle risk behaviours for disease onset.
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