Middle-aged and older Chinese men and women in Singapore who smoke have less healthy diets and lifestyles than nonsmokers.

Although studies in Western populations have shown that smokers have decreased dietary intakes of antioxidants and other health-related nutrients, this has not been established in oriental populations. This study aimed to identify differences in dietary and lifestyle characteristics between current, former, and never-smokers among middle-aged and older Chinese in Singapore. The subjects, 45-74 y old, were participants in the Singapore Chinese Health Study, a prospective cohort that enrolled 63,257 (27,959 men and 35,298 women) Chinese in Singapore between 1993 and 1998. Data on current dietary habits (using a validated, semiquantitative FFQ) and other lifestyle factors were collected through face-to-face interviews. Mean daily intakes of various nutrients were estimated using a food composition table that was specifically developed for this population. The current smoking rates were 36% in men and 6% in women; an additional 22% of men and 3% of women were former smokers. In both sexes, current smokers were less educated, had lower BMI, led a more sedentary lifestyle, and drank more alcohol and coffee than those who never smoked. Current smokers had dose-dependent decreases in the intakes of a wide range of antioxidants, vitamins, fiber, and calcium, but increases in the intakes of cholesterol and nitrosamines compared with people who never smoked. Former smokers had dietary intakes that either were similar to never-smokers or intermediate between current and never-smokers. Our results are consistent with findings among Western populations, and suggest that the unhealthy diet and lifestyle in smokers occur across diverse cultures.