CHICAGO — Older smokers are motivated to quit smoking by very different factors than are younger smokers, and tailoring cessation services to recognize these unique differences can improve quit rates, Virginia Reichert, N.P., said at the annual meeting of the American College of Chest Physicians.
Ms. Reichert and colleagues at the Center for Tobacco Control, North Shore-Long Island Jewish Health System, Great Neck, N.Y., reported the findings of a comparison study of 2,052 smokers; 143 were aged older than 65 years and 1,909 were aged 65 years or younger.
Older smokers were significantly more likely than were younger ones to report quitting smoking because of physician pressure (32% vs. 19%) and a recent change in health status (27% vs. 19%). Younger smokers attributed their reasons for quitting to general health concerns (81% vs. 68%), the cost of cigarettes (37% vs. 22%), and cigarette odor (33% vs. 18%).
Older smokers were significantly more likely than were younger smokers to report a recent hospitalization (23% vs. 13%), a diagnosis of comorbid cardiac disease (78% vs. 38%), cancer (20% vs. 6%), and chronic obstructive pulmonary disease and/or asthma (37% vs. 23%). Significantly more older smokers also reported smoking more than two packs per day (15% vs. 11%).
Older smokers were significantly more likely to report not wanting to give up their first cigarette in the morning as an obstacle to quitting (69% vs. 54%). In contrast, younger smokers were significantly more likely to cite weight gain (29% vs. 15%), handling social situations (24% vs. 7%), and stress relief without cigarettes (59% vs. 45%) as obstacles to quitting.
“With the younger smokers … you can develop strategies to manage stress and weight before they quit, so it's not an issue that will keep them from doing it,” she said.
The two groups did share many similar beliefs, including the surprising finding that the majority of both younger (62%) and older (68%) smokers erroneously believe that nicotine causes cancer. “There's something right there that health care providers can impact, because they're not going to use the patches if they believe nicotine causes cancer,” she said.
Roughly three-fourths of patients in both groups reported feeling guilty about smoking; while 72% of younger and 60% of older smokers worried that smoking would give them cancer. Nearly one-third of patients reported being depressed for much of the previous year, and a similar percentage reported receiving help or medication for their depression.
At 30 days, 57% of younger and 58% of older smokers were smoke free, as verified by a carbon monoxide monitor. Among those who quit, 34% of younger smokers and 52% of older smokers remained smoke free at 1 year, Ms. Reichert said.