Smoking tied to reduced physical activity in adults with respiratory disease

Cigarette smoking and use of heated tobacco products (HTPs) are both linked to lower physical activity in Japanese adults, especially those with respiratory diseases, according to a study.

In this cross-sectional study, the investigators analysed data from the 2023 Japan COVID-19 and Society Internet Survey, including a total of 28,353 participants aged ≥15 years. They classified tobacco use as never, current, or former use of cigarettes and/or HTPs.

The International Physical Activity Questionnaire (IPAQ) was used to assess physical activity, expressed in MET-min/week. The investigators conducted multivariable analyses, applying analysis of covariance, and logistic regression to compare low with moderate/high physical activity, with adjustments for health, demographic, and behavioural factors.

In the ANCOVA model, the predicted means of physical activity were 1,100.9 MET-min/week for never smokers, 1,006.8 MET-min/week for cigarette smokers, and 945.6 MET-min/week for HTP users.

Physical activity was substantially lower among current cigarette smokers (β, ‒94.1, 95 percent confidence interval [CI], ‒176.7 to ‒11.5; p=0.026) and current HTP users (β, ‒155.3, 95 percent CI, ‒252.7 to ‒57.9; p=0.002) than never smokers.

These findings were consistent in sensitivity analyses using log-transformed IPAG scores and logistic regression. In subgroup analyses, HTP users with asthma had reduced physical activity, but no clear pattern was noted for those with chronic obstructive pulmonary disease.

“Smoking cessation, particularly in asthma, should be prioritized, alongside promoting physical activity among tobacco users,” the investigators said.