Older versus younger treatment-seeking smokers: Differences in smoking behavior, drug and alcohol use, and psychosocial and physical functioning

Abstract

Quitting smoking benefits older individuals, yet there are few recent data describing older smokers. The goal of this paper was to test a series of hypotheses about differences between smokers age 50 years and older (50 + ) and those younger than age 50 (<50), presenting to the same treatment facility during 2002-2004 for participation in two randomized clinical trials: one exclusively for smokers age 50 + , and a second open to smokers age18 and older. As predicted, smokers age 50 + were more tobacco dependent, had better psychological functioning, and poorer physical functioning than those <50. Contrary to predictions, there were no differences in motivation to quit cigarette smoking or in alcohol use. Women age 50 + were less likely to report marijuana use than women <50, and less likely to receive a positive diagnosis for alcohol abuse then men. Despite higher scores on measures of tobacco dependence, older smokers were less likely to be diagnosed as tobacco dependent or having tobacco withdrawal using DSM-IV criteria. Rates of DSM-IV alcohol abuse and dependence were high in both age groups but were higher for smokers <50. There were no striking differences between studies in reasons for exclusion, but in both, the proportion of individuals excluded due to current antidepressant use was high. Implications for the assessment and treatment of older adults are discussed.

ACCF/AHA 2011 Expert Consensus Document on Hypertension in the Elderly

“…202,[481][482][483][484] Older smokers who quit reduce their risk of death from CAD, chronic obstructive pulmonary disease, lung cancer, and osteoporosis. [485][486][487] Age does not appear to diminish the desire to quit 488 or the benefits of quitting. 489,490 Treatments shown effective in the US Department of Health and Human Service's Guideline have also been shown to be effective in older smokers.…”

Organic Cation Transporter Variation and Response to Smoking Cessation Therapies

“…These trials were conducted in Washington DC and Philadelphia PA, 40 Washington, 41 California, 42,43 and Wisconsin. [44][45][46] These were treatment efficacy trials, comparing pharmacotherapies with either group or individual behavioral counseling sessions, 40,[42][43][44][45][46] or, a behavioral effectiveness trial comparing behavioral therapy delivery modes.…”

“…These trials were conducted in Washington DC and Philadelphia PA, 40 Washington, 41 California, 42,43 and Wisconsin. [44][45][46] These were treatment efficacy trials, comparing pharmacotherapies with either group or individual behavioral counseling sessions, 40,[42][43][44][45][46] or, a behavioral effectiveness trial comparing behavioral therapy delivery modes. 41 For this analysis, we nominated SNPs (Supplementary Table 4) based on one or more of the following criteria: (a) evidence for genome-wide association with a metabolic phenotype, (b) non-synonymous substitutions or variants likely to be functional, (c) evidence from a candidate gene association study of response to smoking cessation therapies, 10 (d) genotypes from our database, 46 and (e) minor allele frequency ≥ 0.01 in 1000 Genomes or HapMap Utah residents with ancestry from northern and western Europe (CEU).…”

“…Seventy-seven SNPs at the three gene loci (±50kbp) were previously chosen for Illumina GoldenGate® assay synthesis, 68 were genotyped and met quality control criteria, and 674 SNPs were imputed as described 47 in six randomized controlled trials. [41][42][43][44][45][46] We restricted our analyses to self-identified European ancestry individuals to reduce potential heterogeneity of genetic effects across continental population groups. Assessment of genotype completion rates, genotyped or imputed genotypes from nominated or proxy SNPs, linkage disequilibrium, and minor allele frequencies reduced this to six SNPs with genotyped genotype data (Table 2 and Supplementary Table 4).…”

Pharmacological Smoking Cessation Therapies in Older Adults: A Review of the Evidence

“…The Centers for Disease Control and Prevention (CDC) estimate that 8.8 % of individuals 65 years and older in the USA are current cigarette smokers-almost 4 million older adults [2]. Older smokers have been shown on average to be heavier smokers than younger smokers [3], be more likely to have chronic diseases, and have higher levels of nicotine addiction [4]. Biochemically, older adults have been shown to clear nicotine significantly more slowly than younger adults [5].…”