Older adults

  Population considerations:

  • Nicotine Dependency. Older smokers tend to be concerned about the physical dependence on nicotine and perceive this dependence as a barrier to quitting. The withdrawal symptoms that are of most concern to them are cravings, loss of pleasure, irritability, weight gain and inability to concentrate (Hatsukami, 1999).
  • Lack of motivation. Many older adults may be more resistant to quit smoking at this point in their life because they feel that the damage from smoking is already done. Others may feel that since they have already survived this long without any adverse consequences, smoking may not be harmful to them. Older smokers who report fairly good health and lower levels of distress are less likely to quit smoking (Sachs-Ericsson, 2009). Motivational methods may need to be developed to engage this group in smoking cessation treatment (Sachs-Ericsson, 2009). Older adult smokers with higher levels of psychological distress and health problems may be more motivated to quit smoking than those with fewer problems (Sachs-Ericsson, 2009).
  • Lack of prescription. Elderly tobacco users are less likely to receive prescriptions for cessation medications (Steinberg, 2006).
  • Stress reduction and weight control. Older smokers see smoking as an effective coping tool in reducing tension and also perceive smoking as a weight control strategy (Hatsukami, 1999).

  Strategies to address these considerations:

  • Tailor materials. Cessation materials should be tailored to chronic, heavy smokers. They may especially benefit from nicotine replacement therapies to help overcome the heightened withdrawal symptoms from a nicotine addiction of many years.
  • Provide alternatives. Cessation strategies should include an intervention that suggests alternate activities to smoking to help occupy the time that would usually be dedicated to smoking.
  • Increase provider education. Educate providers on the importance of addressing tobacco in this population.
  • Enact Smoke-Free Laws. Smoke-free legislation has had a significant effect on adult smoking rates (Hahn, 2008). “No smoking” policies are the most common method to reduce environmental tobacco smoke in public places (Barbeau, 2004).
  • Educate. Some interventions have used warnings and educational material to deter individuals from smoking in public places. More comprehensive efforts to reduce environmental tobacco smoke include educational campaigns for employees and managers, posting signs about the “no smoking” policy and providing smoking cessation assistance for those who smoke (Barbeau, 2004).

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