The study led by Virginia Reichert, NP, Centre for Tobacco Control, North Shore-LIJ Health System, Great Neck, New York has found that smokers over the age of 65 years reported quitting smoking due to physician pressure and stress due to a major health problem while smokers under age 65 reported cigarette cost and tobacco odour as reasons for quitting.
In the study the health status and motives and obstacles for quitting smoking between 1,909 smokers under age 65 and 143 smokers over age 65 who were attending a 6-week comprehensive cessation program were compared. The analysis showed that the older smokers, i.e. patients above 65 years were more likely than younger smokers, i.e. those below 65 years, to have a recent hospitalisation, 23 percent vs. 13 percent, comorbid cardiac disease 78 percent vs. 38 percent, cancer 20 percent vs. 7 percent and chronic obstructive lung disease/asthma 37 percent vs. 23 percent.
The analysis also revealed that for motivation, older smokers cited pressure by their physician and stress of a major health problem as main reasons for quitting. While younger smokers attributed their reasons for quitting to the cost of cigarettes, tobacco odour, and general health concerns.
"The current common perception among the medical community is that if smokers age 65 and older haven't quit by now, they can't or won't quit - a perception which may lead physicians to focus less on their older patients' smoking habit," Reichert said. "Our results show that older smokers are motivated to quit smoking by very different factors compared with younger smokers. If these factors are addressed, we may see cessation rates improve for both age groups," she said.
"If the cost of cigarettes hasn't made the older smoker quit by now, they are not as likely to be affected by the rising costs as much as younger smokers may be. On the other hand, younger smokers may not have experienced health effects from their smoking, but they may have felt the impact of the cost of cigarettes/cigars," she added. Obstacles to smoking cessation also varied by age group. Younger smokers were more likely than older smokers to report concerns of weight gain 30 percent vs. 15 percent, stress management 59 percent vs. 45 percent, fear of failure 15 percent vs. 8 percent, handling social situations 24 percent vs. 7 percent and cravings 44 percent vs. 36 percent as obstacles to quitting smoking.
In addition, 54 percent of older smokers and 69 percent of younger smokers reported not wanting to give up their first cigarette in the morning as an obstacle to quitting smoking. "To be most effective, treatment plans and education should be relevant to each group's concerns," Reichert said. Reichert suggested that health-care providers offered weight management programs and stress management strategies as part of the treatment and decline prevention programs for younger smokers.
While older smokers may be more successful with physician encouragement and knowledge of how smoking is influencing their current health conditions for giving up smoking. "Tobacco-related diseases are major causes of death in the United States," Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians said.
"The more we know about what motivates smokers to quit their habit and what personal obstacles they face in doing so, the more we can tailor smoking cessation programs to fit the individual needs of our patients," Thomas said.