Smoking history is related to free-living daily physical activity in claudicants

Purpose: To determine whether smoking history was related to free- living daily physical activity in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication, and whether the effect of smoking history on physical activity level persisted after controlling for group differences in ambulatory function, peripheral circulation, and body composition. Methods: Patients were separated into three groups: those who never smoked (N = 35), those who had a lower pack-year history of smoking (≤ 40 pack-yr; N = 33), and those who had a higher pack-year history (> 40 pack- yr; N = 30). Free-living daily physical activity was assessed by activity monitors (an accelerometer and a pedometer) worn on each hip over 2 consecutive weekdays. Patients also were characterized on ambulatory function, peripheral circulation, and body composition because of their relationship with physical activity. Results: A progressive decline (P < 0.001) in free-living daily physical activity with increasing smoking exposure was obtained from the accelerometer in the nonsmokers (482 ± 36 kcal · d^-1; mean ± SE), smokers with a lower pack-year history (361 ± 37 kcal · d^-1), and smokers with a higher pack-year history (227 ± 23 kcal · d^-1). A similar decline was found with the pedometer data (P < 0.001). After controlling for group differences in 6-min walk distance and in calf transcutaneous heating power, group differences in free-living daily physical activity were no longer significant. Conclusion: Progressive decrements in free-living daily physical activity with greater levels of smoking exposure in PAOD patients are primarily due to smoking-related impairments in ambulatory function and peripheral circulation.