Smoking cessation behavior in older adults by race and gender: The role of health problems and psychological distress

Abstract

vational methods may need to be developed to engage this group in smoking cessation treatment. IntroductionCigarette smoking is the leading cause of premature death among older adults. Older adults who are cigarette smokers have increased medical problems, health care costs, disability, and mortality ( Fillenbaum, Burchett, Kuchibhatla, Cohen, & Blazer, 2007 ;Hsu & Pwu, 2004 ;Rapuri, Gallagher, & Smith, 2007 ). Smoking predicts quality of life as well as mortality ( Ferrucci et al., 1999 ). That is, nonsmokers not only have longer lives, but this increased life expectancy is also associated with more disability-free years of life ( Fried, 2000 ). Given the rapid growth of the elderly population, we expect the medical, social, and economic consequences of smoking among older adults to become a greater burden over the next several decades.Elderly individuals who have smoked for 3 -4 decades can benefi t substantially by abstaining from cigarette smoking. In their review of the literature on the positive effects of smoking cessation among older adults, LaCroix and Omenn (1992) concluded that older smokers who quit smoking have a reduced risk of premature death, markedly reduced risk of coronary events, slower decline in pulmonary function, and slower progression of osteoporosis, thus reducing the risk of hip fractures. Given the severity of health problems associated with smoking in older adults and the signifi cant health benefi ts from quitting smoking even after decades of smoking, understanding characteristics of older smokers and smoking cessation patterns is vital in the development of specialized cessation programs.In the general population, a number of demographic characteristics are related to quit attempts and successful quits. According Abstract Introduction: Initial research on older smokers suggests that a subgroup of smokers with higher levels of psychological distress and health problems may be more likely to quit smoking than older smokers with fewer such problems. The present study, based on prospective data from a biracial sample of older adults ( N = 4,162), examined characteristics of older adult smokers by race and gender. Methods:The present study uses both cross-sectional and prospective data to examine the association between smoking behavior, smoking cessation, health functioning, and psychological distress in a biracial sample of community-dwelling older adults. Results:We found baseline psychological distress to be associated with poor health functioning. Consistent with hypotheses, baseline (Time 1) psychological distress predicted smoking cessation 3 years later (Time 2). Moreover, the change in health problems between Time 1 and Time 2 fully mediated the association between Time 1 distress and smoking cessation.Discussion: Smoking cessation behavior of older adults is best explained by higher levels of distress and health problems regardless of race or gender. These fi ndings may have important treatment implications regarding smoking cessation programs among older adults. Older adult ...

Pattern of Tobacco Use and its Correlates among Older Adults in India

“…However elderly smokers are less likely to get cessation advice (Salive et al, 1992;Maguire, et al, 2000;Schmitt et al, 2005;Tait et al, 2006) who are more likely to be successful at quitting (Abdullah, et al, 2006;Donze et al, 2007). Education on cessation is needed for both health care professionals and elderly 2000; Schmitt et al, 2005;Sachs Ericsson et al, 2009).…”

Tobacco smoking in older people

“…Unfortunately, there is evidence that elderly smokers in the UK and USA are far less likely to receive smoking cessation advice from their primary care doctors compared with younger patients, despite the fact that they consult more frequently. 47 There have been some studies of smoking cessation interventions that have specifically addressed the needs of older smokers. A recent study carried out in the USA showed that an intensive group therapy approach, supported by specialists in geriatric social work and smoking cessation was highly effective, with a sustained quit rate of 68% at 12 months.…”

“…Successful smoking cessation appeared to be closely related to alleviation of their social and psychological problems. 47,48 The evidence for the utility of nicotine replacement therapy (NRT), such as nicotine trans-dermal patches, is strong for older people. Further, NRT is even more effective when combined with various forms of behavioural support, such as counselling and the provision of written information.…”

The role of mental illness on cigarette dependence and successful quitting in a nationally representative, household-based sample of U.S. adults

“…One prospective study of more than 4,000 adults in the United States found that the relationship between depression symptoms and smoking cessation was not significantly moderated by gender or race. However, that study only included white and black respondents and it did not examine age (22). Moreover, the study focused only on depression symptoms and did not evaluate other mental illnesses.…”