The National Center for Tobacco-Free Older Person

Smoking Cessation, Quality

of Life & Older Persons
The Center for Social Gerontology
2307 Shelby Avenue, Ann Arbor, MI 48103 tel: 734 665-1126 fax: 734 665-2071

This site is intended to provide information on and access to materials concerning smoking cessation, the effects of smoking cessation on the health of older persons, and the value of healthy lifestyles for older persons, which include not smoking or being subjected to secondhand smoke. Since this portion of this site has been created in August, 2000, we will largely be including materials and articles below which are published after this date; for references to materials on this subject published prior to this date, go to the section of this site titled Bibliography of Tobacco & Older Persons Articles. Additional materials will be added to this site on a regular basis.

Related information can be found on the following sections of this web site: Tobacco-related Health Problems & Older Persons; Tobacco & the Elderly Notes newsletters; and the Smoke-Free Environments Law Project site, particularly the ETS & Health Effects portion of that site.

The following are materials/articles/resources related to this topic (simply click on the underlined headings to access the full articles/materials/resources):



Report of First-ever Focus Group Study of Older Smokers & Former Smokers

The Center for Social Gerontology (TCSG) contracted with Performax to conduct the first-ever series of focus groups of current and former smokers who are 60 years of age or older. The focus groups were held in October and November, 2001, and the report of the findings was prepared for TCSG in December, 2001 by Performax. The focus group study was intended to provide insights into the motivations, opinions and behaviors of older persons about tobacco use and cessation, including to identify key motivators, resources and tobacco cessation aids used successfully by former smokers. The study also sought to identify key barriers that have prevented current smokers from quitting successfully, and to identify the media formats which could be used to most effectively reach and communicate with older smokers. The findings of this study may be accessed, in pdf format, by clicking above. To access a description of the focus group project and a summary of the focus group findings, click here.


Smoking Cessation & Older Persons Brochure

TCSG has designed a smoking cessation brochure which targets older adults. Organizations which would find this brochure useful, are welcome to download it, print it out, and distribute it.

Smoking Cessation Links for Smokers

This list of links was created tohelp individuals become nicotine-free. The websites included in the list contain information on nicotine dependence, tips for quitting, available resources, chat rooms, e-cards to encourage individuals to quit, counseling, and more.

Smoking Cessation Hotlines & Helplines

A list of national as well as statewide cessation helplines has been compiled; many of the statewide hotlines are available only to residents of that state, and for most of them, access to the number is available only when calling from a phone number within that state.

Smoking Cessation Links for Health Care Providers & Policymakers

This list of smoking cessation links includes some of the best sources for smoking cessation information on the web. The sites included in the list are especially useful for anyone who is working on smoking cessation policy or providing health care.

Bibliography of Smoking Cessation Articles Concerning Older Adults

This bibliography, prepared by The Center for Social Gerontology in July, 2001, presents a comprehensive, albeit not all-encompassing, list of recent articles on smoking cessation and nicotine reduction concerning older adults, including minority older adults. Most of the articles in this listing were published after 1996 because TCSG's Bibliography of Tobacco and the Elderly Articles which can be accessed here, include a section on "Smoking Cessation," which lists articles on this topic largely published between the late 1980s and 1996. TCSG has produced this bibliography in the hope that it will assist others in conducting further research on smoking cessation and nicotine reduction targeted to older adults, and that it will encourage others to establish smoking cessation and nicotine reduction programs which focus on older adults.



Record Number of Wisconsin Senior Smokers Quit Through Wisconsin Tobacco Quit Line Program

On November 13, 2003, the University of Wisconsin Center for Tobacco Research and Intervention (CTRI) issued a press release which described the initial results of an evaluation of a Wisconsin Tobacco Quit Line program which targeted older smokers during the period of May through August, 2002. The program provided free nicotine patches and phone counseling, as well as a "quit kit." The results of the program were extraordinary. More than 43% of the senior participants successfully quit, based on a survey conducted nine months after enrollment. In contrast, research shows that quitting "cold turkey," or without any help, is successful for only about 5% of people. The 43% abstinence rate among the seniors, among the highest ever reported, contradicts the belief that older smokers are less interested or able to quit. During the program, 1,800 Wisconsin seniors called the Quit Line and 1,300 enrolled for telephone counseling and free nicotine patches. More than 90% of the callers set a quit date. Among those who were unable to quit successfully, more than 80% still wanted to stop and 44% were planning to quit within 30 days. Dr. Michael Fiore, director of CTRI, which manages the Quit Line, was delighted that the program helped so many seniors quit tobacco use. "This evaluation clearly demonstrates that, contrary to popular notions, senior smokers are eager and ready to quit when given access to effective cessation services, such as the Quit Line and medication. It's never too late to quit smoking and reap the benefits of better health." The program was sponsored by the UW-Center for Tobacco Research and Intervention, the Wisconsin Women's Health Foundation and the Wisconsin Department of Health and Family Services. The full evaluation of the Wisconsin Senior Patch program will be available on December 1, 2004. To access a copy of the Nov. 13, 2003 press release, in pdf format, click above.

Graphic images convince smokers to quit: study

Graphic images on cigarette packs may be the best way to convince smokers to quit, according to a new European study, released on August 4, 2003. The investigation by the University of Strathclyde in Scotland looked at images on Canadian cigarette packages, which include large photos of yellowed teeth, diseased gums and a lung tumor. The study was commissioned by the European Union and could lead to graphic warnings on European cigarettes. It was presented on August 4, 2003 at a global tobacco and health conference in Finland. The results are culled from interviews done in seven countries: Britain, Finland, France, Germany, Greece, Spain and Sweden. It involved 56 focus groups with people ranging from 16 to 64 years of age; thus, the study did not include persons 65 and over, but the results are likely to be relevant for older smokers, as well. Click above to access the news story on this research. To access a press release on the research, click here.

State Medicaid Coverage for Tobacco-Dependence Treatments -- United States, 1998 and 2000

The U.S. Centers for Disease Control & Prevention on November 9, 2001 released the results of a 50-state survey of State Medicaid Coverage for Tobacco-Dependence Treatment. This very useful report was published in Morbidity & Mortality Weekly Report and may be accessed through this link.

Smoking Cessation & the Elderly Best Practice Publications and Programs

The Center for Social Gerontology has compiled a list of publications and/or program descriptions which are particularly germane for smoking cessation and the elderly. When possible, we have included a link to the full publication or the abstract.

Smoking Cessation & Older Persons: A Case Example

This February 5, 2001 news story describes the experience of a 60 year old man who successfully completed a smoking cessation course after having been a smoker for more than 45 years. The Chicopee resident, Roger Carrington, enrolled in the Freedom From Smoking class at Baystate Medical Center in Springfield, Massachusetts and, when the news article was written, he had not had a cigarette for 17 days; this was the longest he had quit since he started smoking at the age of 12 or 13. Mr. Carrington had discovered how addictive smoking was this past fall when he had pneumonia but continued smoking through the entire illness. Soon afterward, his wife convinced him to quit, which he has done with a combination of the course and the antidepressant Wellbutrin. Carrington says he is already feeling healthier. This article describes the experiences of a number of persons who also went through the course. The article demonstrates that smokers can quit at any age, and that positive health effects can be felt within a very short time. [This article may no longer be available online.]

New Treatments for Smoking Cessation

This article by Dr. John Hughes appeared in CA: A Cancer Journal for Clinicians in the May/June, 2000 issue and and provides a concise summary of new treatments for smoking cessation for persons of all ages, including older persons. The article discusses basic facts about smoking, treatments, nicotine replacement therapies and methods of motivating smokers to try to quit. To access the abstract of the study, click the main title link above. To access a pdf document containing the full text, please click here.

Medicare Recipients with Heart Conditions Rarely Told to Quit Smoking

In the October 4, 2000 issue of the Journal of the American Medical Association (JAMA) in an article titled Quality of Medical Care Delivered to Medicare Beneficiaries the authors reported that only about 40% of the time were Medicare beneficiaries who had suffered heart attacks provided with smoking cessation counseling by their medical care provider. The article reports on a variety of quality of care indicators for each state and provides state-specific data, e.g., 69% of Medicare beneficiaries in Wyoming were advised to quit smoking (the highest state), 42% of Michiganians were (close to the median of 40%), and just 19% of Texans were (the lowest state). This clearly suggests a need for the medical community to increase its efforts to inform older smokers of the value of quitting smoking. This analysis looked only at Medicare beneficiaries who were served in the traditional fee-for-service system, not in managed care settings; see article below for data on managed care Medicare recipients, where about 70% of older persons were advised about smoking cessation. Click above for JAMA abstract; full article is only accessible to JAMA subscribers.

Medicare Managed Care Recipients Not Always Advised to Quit Smoking

The September 8, 2000 Morbidity & Mortality Weekly Report has a feature article titled Receipt of Advice to Quit Smoking in Medicare Managed Care -- United States, 1998. This is one of the first, if not the first, such analyses of whether Medicare recipients are routinely being advised to quit smoking when they go for medical appointments. The report notes that 29% of Medicare recipients enrolled in Medicare managed care plans who visited their doctor in the past year were not advised to quit smoking. The report points out that, while only about 13% of Medicare recipients are smokers, "older smokers are at greater risk from smoking because they have smoked longer, tend to be heavier smokers, and are more likely to suffer already from smoking-related diseases." The report emphasizes the need for health care providers to encourage all smokers, including older persons, to quit smoking. The report notes that African Americans and Hispanics received less advice to quit than did whites, as did smokers aged 75 and over. The charts provide break-outs of smoking data by various age groups of persons aged 55 and over.

Elderly Smokers Also Benefit From Quitting

A new research review by Dr. David Burns confirms that quitting smoking at any age is beneficial. The study, published in the July/August, 2000 issue of the American Journal of Health Promotion, demonstrates that older smokers, whether heavy or light smokers, will achieve improved health by quitting, even among smokers aged 70 and over. Burns stated: "This is a population where preventive services should not be ignored." Burns said that elderly smokers can bounce back after quitting and gain health benefits, although not as significantly as younger smokers. He also points out that, even among diseases such as COPD, where the damage due to smoking is not reversible, quitting can prevent further complications. [This study is no longer available online.]

Freedom and Quality of Life

The August, 2000 issue of the Journal of Epidemiology and Community Health contains an editorial titled "Freedom and Quality of Life," which comments on an article in that issue of the Journal titled "Smoking and the Compression of Morbidity" (see link to article below) and points out that the findings are similar to those in earlier studies by Vita and colleagues and by Furrucci and colleagues. The editorial states that the study "shows that smoking is a cause of a great number of years lived with disability, [and] is the best answer we can give to those who think that smoking would save money by killing smokers before they get too old and disabled." Article no longer available online, except to subscribers.

Study gives Medicare a better prognosis; Living longer will not necessarily translate into steeper health-care costs, research found

According to a September, 2003 news report: More "golden years" do not cost the health-care system more, federal researchers say, calculating that medical costs are about the same for people who are healthy at age 70 and live independently for many more years and those who are sickly and die sooner. The findings have big implications for taxpayers, because they suggest that the outlook for the Medicare program as America's baby boomers grow old might not be as dire as some policymakers feared. Given projections saying the baby-boom generation will bankrupt the Medicare trust fund in about 25 years, politicians and economists have wondered whether the increasing longevity of healthier senior citizens would increase or reduce Medicare spending. Neither, say National Center for Health Statistics researchers. They found medical expenses from age 70 until death averaged $140,700, with little difference between active, long-lived senior citizens and disabled ones, except for those already in a nursing home. "Improving health should be the overall goal of our health-care policy, but it's not going to save the Medicare system," said Jim Lubitz, acting chief of the Aging Studies Branch in the statistics center's Office of Analysis, Epidemiology and Health Promotion. Sandra Decker, a researcher at the International Longevity Center-USA, said Medicare costs would rise because of the sheer number of beneficiaries, not their longer life span. "It means, yes, we'll spend more on Medicare, but maybe not as much more as we thought," she said. Uwe Reinhardt, a professor and health economist at Princeton University, said 70-year-olds today had far fewer disabilities than their counterparts a couple of decades ago, when economist Victor R. Fuchs first reported that longevity did not affect health-care spending much. Reinhardt said the new study provided updated numbers on those costs. The study is reported in the September 11, 2003 New England Journal of Medicine. Click above to access the abstract of the study. To access the full text of the study, click here. You will need to be a registered user or an activated subscriber to NEJM. Becoming a registered user of most major online journals allows free access to past issues six or twelve months old and older.

Smoking and the Compression of Morbidity

Recently, there have been a number of studies which have examined the question of whether eliminating smoking will lead to a reduction in the number of years lived with disability. Or, put another way, will stopping smoking enable persons to not only live longer, but live a better quality of life right up to death. A new study, published in the August, 2000 issue of the Journal of Epidemiology and Community Health, titled "Smoking and the Compression of Morbidity," by Nusselder, et al, looked at this question and concluded that "eliminating smoking will not only extend life and result in an increase in the number of years lived without disability, but will also compress disability into a shorter period." This is an important study, with a wealth of data. Click above for the abstract; the full article is no longer available online except to subscribers.

Smoking Cessation and Risk of Age-Related Cataract in Men

This article in the August 9, 2000 issue of the Journal of the American Medical Association states that smoking has been shown to be a risk factor for the development of age-related cataract and concludes that, while some smoking-related damage to the eye lens may be reversible, smoking cessation reduces the risk of cataract primarily by limiting the total dose-related damage to the lens. The study found that men who had quit smoking had a 23% reduced risk of cataract diagnosis and a 28% reduced risk for cataract extraction (a surgical treatment) compared to men who currently smoked. The authors found that even the most heavily exposed men benefited from smoking cessation, at any age. Click above for abstract; full article is available only to JAMA subscribers.

Healthy Lifestyles & Tobacco: A Healthy Old Age Equals No Smoking

The Spring/Summer, 1999 issue of TCSG's Tobacco & the Elderly Notes newsletter contains this article which examines the relationship of smoking to people living a healthy old age. The article includes references to the conclusions found in the excellent 1998 book "Successful Aging" by Drs. Rowe and Kahn. Included is information on mortality, premature deaths, the debilitating effects of tobacco-related diseases on quality of life, the perceptions of smokers about the risks of smoking, and information on smoking cessation. Photos of tobacco ads which today's elders to tobacco are included.

The Center for Social Gerontology, Inc.
2307 Shelby Avenue  Ann Arbor, MI  48103
Tel: (734) 665-1126  Fax: (734) 665-2071