Effects of changes in smoking status on blood pressure among adult males and females in Indonesia: a 15-year population-based cohort study

OBJECTIVES: The continuing rise of smoking behaviours will inevitably lead to a further increase in hypertension prevalence. However, limited research has examined the impacts of changes in smoking status on blood pressure (BP). We sought to assess correlations between increases or decreases of males’ and females’ cigarette consumption on systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP), and to investigate the relationship between smoking status changes and changes in BP through a 15-year examination period. DESIGN: Retrospective, cohort study. SETTING: We used nationally representative secondary data collected in the years 2000, 2007 and 2015 by the Indonesia Family Life Survey. PARTICIPANTS: We measured the smoking habits, BP indices and other socioeconomic factors documented in the multiple follow-up surveys of a sample of 10 338 respondents. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the means of SBP, DBP and PP. The secondary outcome was the changes from baseline in SBP and DBP. RESULTS: Smoking caused different effects on male and female smokers. Female smokers who increased their daily cigarette consumption had significantly higher SBP and PP (p<0.001). During 15 years of follow-up, male and female smokers who decided to quit had the largest change of SBP (adjusted mean=16.64 mm Hg, SE=21.39 and adjusted mean=24.78 mm Hg, SE=23.25, respectively), whereas new male and female smokers exhibited the highest change of DBP (adjusted mean=2.86 mm Hg, SE=11.50 and adjusted mean=7.54 mm Hg, SE=14.39, respectively). CONCLUSIONS: Our study confirmed the adverse effects of smoking on BP, which can be used to inform efforts to tackle the growing cigarette epidemic and its negative effects on hypertension among former and new smokers and develop evidence-based tobacco control policies in Indonesia.