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Programs that successfully reduce or prevent smoking and alter sedentary lifestyles can reduce hospital admissions

Smoking and a sedentary lifestyle remain the leading causes of death in the United States. Hospital admissions can be substantially reduced by interventions to prevent smoking, help smokers quit, and encourage inactive people to become active, according to a study supported by the Agency for Healthcare Research and Quality (HS07002). The study findings suggest that eliminating smoking and inactivity would reduce annual rates of hospitalization among older adults 11 percent and 7 percent, respectively, 5 years later and 9 percent and 5 percent, respectively, 20 years later.

Overall, men gain more from smoking cessation and women more from increasing exercise. Smoking cessation had its greatest impact for men aged 45-64, with reductions in the hospitalization rate of 17 percent in year 5 and 14 percent in year 20. Reductions in hospitalization for women aged 45-64 and men aged 65-74 also were substantial, while those for women aged 65-74 were a mere 1 percent. The elimination of sedentary lifestyles had the greatest impact on women. Their hospitalization rates fell 8 to 10 percent during followup, while the rates for middle-aged men fell less than 5 percent and those for elderly men less than 2 percent.

However, if only 10 percent of individuals who smoked or were sedentary changed their behavior—a percentage that reflects the effectiveness of current interventions—then hospitalization rates would decline less than 2 percent in all age-sex groups, explains Louise Russell, Ph.D., of Rutgers University. Using data from a representative sample of nearly 8,000 U.S. adults, Dr. Russell and her colleagues linked clinical/behavioral determinants of hospitalization and simulation modeling of health outcomes to develop a model projecting the impact of risk factor modification on subsequent hospitalizations over a period of 20 years.

See "Preventable smoking and exercise-related hospital admissions: A model based on the NHEFS," by Dr. Russell, Steven M. Teutsch, M.D., M.P.H., Rizie Kumar, M.A., and others, in the January 2001 American Journal of Preventive Medicine 20(1), pp. 26-34.

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