By Aldrich, Nancy
Aging Today , Vol. 29, No. 3
New options to help people quit smoking and deeper understanding of the importance of tobacco cessation for older adults have led to a new focus on smoking cessation among elders, according to a report released to media during the Aging in America Conference of the National Council on Aging and American Society on Aging in Washington, D.C., in March.
Prepared by the Centers for Disease Control and Prevention (CDC) and the National Association of Chronic Disease Directors, the report notes that of the 45.3 million people who smoke cigarettes in the United States, about 13 million are age 50 or older, with 4.5 million ages 65-plus. Older smokers constitute two-thirds (68%) of all deaths from tobacco smoking, say statistics from the United States Public Health Service (PHS).
"The single best step that smokers can take to protect their health-and that of nonsmoking family members-is to quit smoking," said Matthew McKenna, director of the CDC's Office on Smoking and Health. He added, "Quitting smoking has immediate as well as long-term benefits, including reducing risks for dis eases caused by smoking such as cancer, heart disease, stroke and respiratory illnesses. Fortunately, there are now more options than ever to help someone quit using tobacco, and it's important to remember that it's never too late to take this important step."
The CDC has found that 57% of smokers 65 or older indicate they want to quit. However, McKenna said that quitting tobacco use is complex and involves not only physical addiction but also emotional and psychological components-as well as a complete change in daily routine.
Healthcare and service professionals should be aware that older smokers are likely to be longtime tobacco users, McKenna said. He emphasized that seniors may be in the midst of a health crisis that precipitated a desire to quit or they may be facing huge life changes, such as loss of their independence or death of a spouse, in addition to the challenge of giving up smoking. Also, older smokers may be motivated to quit by the desire to live longer in order to spend time with their grandchildren or to keep their family members from being exposed to secondhand smoke.
The CDC media background report, part of a series of papers initiated with the American Cancer Society in 2002, cites focus-group findings from the Center for Social Gerontology (TCSG). Based in Ann Arbor, Mich., the center found that physicians and other medical professionals are probably the best catalyst for getting older adults to quit smoking. Among elders who had recently quit, advice from professionals had more influence than counsel from family or friends, said TCSG codirector James Bergman, who is director of the Smoke-Free Environments Law Project.
For patients willing to quit, according to the CDC, healthcare professionals should:
* Assist with setting a quitting date;
* Outline the plan;
* Provide self-help materials that are culturally, educationally and age-appropriate for each patient;
* Discuss medication use to reduce withdrawal symptoms, unless contraindicated.
In its 2006 document titled A Practical Guide to Working With Health-Care Systems on Tobacco- Use Treatment, the CDC outlines ways in which healthcare professionals can promote access to effective treatment for tobacco dependence. For example, physicians can provide brief counseling to patients who use tobacco or have recently quit, as well as refer patients to quitlines and other available cessation resources. Professionals can offer first-line tobacco-dependence pharmacotherapies approved by the Food and Drug Administration (FDA) to all tobacco users who are trying to quit. In a hospital setting, healthcare practitioners can provide inpatient tobacco-dependence consultation services and medication, as well as ensure that discharged patients are referred to a quitline or other services for ongoing counseling and follow-up. …