Associations of healthy lifestyle, smoking dependence, and alcohol use with self-reported noncommunicable disease status among U.S. adults

ABSTRACT Context: Noncommunicable diseases (NCDs) remain a major public health concern. Many studies examine lifestyle behaviors individually. The Healthy Lifestyle Screening Tool (HLST) provides a composite assessment across multiple lifestyle domains. Aims: This study examined the associations of self-reported NCD status with healthy lifestyle scores, alcohol use, smoking dependence, and sociodemographic characteristics among U.S. adults. Settings and Design: This cross-sectional study analyzed data from a U.S. adult sample survey. Materials and Methods: A total of 311 participants were categorized by HLST risk, smoking dependence, alcohol use, and sociodemographic characteristics. NCD status was defined as self-reported diabetes, hypertension, or hyperlipidemia. Statistical Analysis Used: Pearson’s chi-square test and multivariable binary logistic regression analyses were employed to examine the factors associated with self-reported NCDs. Results: Participants classified at higher HLST risk were more likely to report an NCD. Marital status was significantly associated with self-reported NCD status, while smoking dependence and alcohol use showed no significant association. Age group and HLST risk category also showed a statistically significant association with self-reported NCD status. Conclusions: Higher HLST risk categories were associated with a greater prevalence of self-reported NCD status in the study sample. These findings support further investigation of the HLST as a multidimensional lifestyle assessment measure. However, the cross-sectional design, self-reported outcomes, convenience sampling, and lack of independent validation of the HLST cutoff scores preclude conclusions regarding prediction, causation, or clinical risk stratification. Prospective studies are needed to examine the temporal relationships between lifestyle behaviors, sociodemographic factors, and incident NCDs.