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"The current common perception among the medical community is that ifsmokers age 65 and older haven't quit by now, they can't or won't quit -- aperception which may lead physicians to focus less on their older patients'smoking habit," said lead study author Virginia Reichert, NP, Center forTobacco Control, North Shore-LIJ Health System, Great Neck, New York. "Ourresults show that older smokers are motivated to quit smoking by verydifferent factors compared with younger smokers. If these factors areaddressed, we may see cessation rates improve for both age groups."
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Ms. Reichert and colleagues from the Center for Tobacco Control at NorthShore-LIJ compared health status and motives and obstacles for quittingsmoking between 1,909 smokers under age 65 (younger smokers) and 143 smokersover age 65 (older smokers) who were attending a 6-week comprehensivecessation program. Older smokers were more likely than younger smokers to havea recent hospitalization (23% vs 13%), comorbid cardiac disease (78% vs 38%),cancer (20% vs 7%), and/or chronic obstructive lung disease/asthma (37% vs23%). Regarding motivation, older smokers cited pressure by their physicianand stress of a major health problem as main reasons for quitting. Youngersmokers attributed their reasons for quitting to the cost of cigarettes,tobacco odor, and general health concerns.
"If the cost of cigarettes hasn't made the older smoker quit by now, theyare not as likely to be affected by the rising costs as much as youngersmokers may be," said Ms. Reichert. "On the other hand, younger smokers maynot have experienced health effects from their smoking, but they may have feltthe impact of the cost of cigarettes/cigars."
Obstacles to smoking cessation also varied by age group. Younger smokerswere more likely than older smokers to report concerns of weight gain (30% vs15%), stress management (59% vs 45%), fear of failure (15% vs 8%), handlingsocial situations (24% vs 7%), and cravings (44% vs 36%) as obstacles toquitting smoking. Furthermore, 54% of older smokers and 69% of younger smokersreported not wanting to give up their first cigarette in the morning as anobstacle to quitting smoking.
Young smokers also believe that trying to quit "cold turkey" is best, whenin reality, only 7% of smokers achieve long-term abstinence withoutprofessional help.
"To be most effective, treatment plans and education should be relevant toeach group's concerns," said Ms. Reichert. She suggests that health-careproviders offer weight management programs and stress management strategies aspart of the treatment and relapse prevention programs for younger smokers,while older smokers may be more successful with physician encouragement andknowledge of how smoking is influencing their current health conditions.
"Tobacco-related diseases are major causes of death in the United States,"said Alvin V. Thomas, Jr., MD, FCCP, President of the American College ofChest Physicians. "The more we know about what motivates smokers to quittheir habit and what personal obstacles they face in doing so, the more we cantailor smoking cessation programs to fit the individual needs of ourpatients."
CHEST 2007 is the 73rd annual international scientific assembly of theAmerican College of Chest Physicians, held October 20-25 in Chicago, IL. ACCPrepresents 17,000 members who provide patient care in the areas of pulmonary,critical care, and sleep medicine in th
