Association between smoking status and sarcopenia among middle-aged and older adults: finding from the CHARLS study

Purpose There is limited information on the association between smoking/smoking cessation and sarcopenia in Chinese populations. We conducted a retrospective cohort study to investigate the association between smoking/smoking cessation and its duration with the risk of sarcopenia. Methods This cohort included 6,719 adults over 45 from the CHARLS between 2011 and 2015. Smoking status was categorized into smokers (current smokers/quitters) and non-smokers. Duration of smoking was defined as < 20, 20-29, 30-39, and >= 40 years. Duration of smoking cessation was defined as <= 1, 2-4, and > 4 years. Sarcopenia was defined according to AWGS 2019. Cox proportional hazards regression models were used to estimate the hazard ratio for the risk of developing sarcopenia. Results The median age of the cohort was 57.0 years, and 47.0% were male. Over a 3.7-year follow-up period, 9.7% of participants developed sarcopenia. Compared to non-smokers, smokers had a higher risk of developing sarcopenia (HR: 1.27, 95% CI 1.02-1.59). Among individuals with a smoking duration exceeding 40 years, the likelihood of developing sarcopenia was 39.0% higher (HR: 1.39, 95% CI 1.08-1.79). The elevated risk persists regardless of alcohol consumption. Quitters had a lower risk of sarcopenia compared to current smokers (HR: 0.67, 95% CI 0.47-0.97). Individuals who had quit smoking for > 4 years had a lower risk of sarcopenia compared to current smokers (HR: 0.43, 95% CI 0.24-0.78). ConclusionCurrent smokers face a higher risk of sarcopenia, especially those with a prolonged smoking history. Promoting smoking cessation is an essential strategy for lowering the risk of sarcopenia and mitigating its burden among smokers.