The Center for Social Gerontology 
Tobacco & the Elderly Project
Fall/Winter 1996
2307 Shelby Avenue, Ann Arbor, Michigan 48103  
Tel: 734-665-1126  Fax: 734-665-2701  

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Of 415,690 smoking-related deaths in the U.S. annually, 94.4% are of persons aged 50 and over. Persons aged 65 and over constitute 70.3% of smoking-related death victims.* No other cause of diseases comes close to tobacco in terms of the epidemic of deaths that result from it.

Of the 415,690 deaths due to smoking-related diseases, 392,364 deaths are of persons aged 50 and over; 292,157 are to persons aged 65 and over.*

Tobacco has been called a "pediatric disease" because children are the targets of tobacco industry advertising, and childhood is when 90% of current smokers were addicted. However, tobacco is also a "geriatric disease" because that is when the disease, suffering and death caused by tobacco overwhelmingly occurs.

I consider hospitals and nursing homes to be the
real "Marlboro Country."

Frank J. Kelley, Michigan Attorney General

Further, 53,000 people die annually in the U.S. from Environmental Tobacco Smoke (ETS) or second-hand smoke-related diseases. Applying the same percentages of smoking-related deaths to ETS-related deaths, then over 50,000 of these deaths are to persons aged 50 and over; and, over 37,000 of these deaths are to persons aged 65 and over.

Michigan Attorney General Frank J. Kelley summed up the dangers of tobacco and its impact on older persons when he said, "I consider hospitals and nursing homes to be the real 'Marlboro County.'" (Attorney General Kelley recently filed a lawsuit against the major tobacco companies seeking over $14 billion to reimburse Michigan taxpayers for the public health costs resulting from smoking.)

Premature Deaths Due to Tobacco

The human impact of these startling figures hits home when one realizes that tobacco-related deaths are generally premature deaths. Life expectancy of smokers is substantially less than that of non-smokers or of persons who quit smoking.

The average years of life lost by each smoking-related disease victim is 12.1 years -- more than a decade of potentially relaxing, enjoyable retirement. In the U.S. in 1990, over 5 million years of life were lost due to smoking-related deaths. And, almost all these lost years were to persons aged 50 and over.

All too frequently, smokers point to George Burns or other smokers who have lived long lives to support their case (or hope) that they need not worry about premature death. In fact, 30-40% of smokers die prematurely from smoking-related diseases. Those who die prematurely from smoking lose 12-15 years of life versus non-smokers. In effect, this means that smokers who resist quitting because they believe they won't die prematurely are playing Russian roulette with 2 bullets in the 6 chambers of the gun; losing means they lose 12-15 years off their lives.

Tobacco-Related Diseases

Tobacco-related diseases not only cause premature deaths, they frequently cause painful deaths. All three major causes of death among the elderly are associated with smoking and/or ETS -- heart disease, cancer and stroke.

In cultures such as the U.S. where smoking has been an established behavior for many decades, smoking is estimated to cause nearly 17% of all deaths. About 35% of all cancer deaths are due to smoking, but 90% of all lung cancer deaths are from smoking. And, 15% of stroke deaths and 22% of heart disease deaths are caused by smoking.

Smoking Rates Among Elders

Smoking rates of today's generation of older Americans -- that is, those persons born between 1910 and 1945 who are now aged 50 to over 85 -- were among the highest of any U.S. generation. Smoking rates ballooned in the 1950's and 1960's, reaching their peak in the mid-1960's. This was the period when most of today's elders were in their late teens or their 20's and 30's.

In 1965, there were an estimated 54 million adult smokers, or 43% of all adult residents of the U.S. Of adult males aged 18 and over, 53.4% were smokers, and 21% were former smokers. Of adult females aged 18 and over, 34% were smokers, and 8% were former smokers. Some age groups of men had smoking rates of over 70%. Many of these persons started smoking the unfiltered favorites of the day -- Camels, Chesterfield, Lucky Strike and Philip Morris. Many men also smoked pipes and cigars, as well as cigarettes.

During the 1950's, filter tipped cigarettes began to be marketed with a passion, and many of today's elders switched from unfiltered to filtered cigarettes. While the cigarette companies promised that filtered cigarette smoke was better for health, this was just one more lie. In fact, Kent for a period of time had asbestos in their filters.

With the release of the first Surgeon General's report on smoking in 1964 and with increasing numbers of scientific reports linking smoking to cancer, heart disease and other illnesses, smoking rates among adults began to drop. By 1985, there were still 54 million adult smokers, but smoking rates had dropped to 30% of the adult population. Adult male smoking rates had dropped to 33%, a very significant reduction. Adult female smoking rates had dropped to 28%, a much smaller reduction, reflecting the dramatically increased cigarette advertising targeted to women and girls.

By 1994, 25.5% of adults in the U.S. were smokers -- 48 million adults. Smoking rates of adult men and women had continued to decrease, with 28% of men (25 million) and 23% of women (23 million) still smokers.

Strikingly, the 1994 smoking rates of men and women between the ages of 18 and 64 were consistently in the range of 22% to 32%, but the smoking rates of persons aged 65 and over dropped to about 12%, with men having a 13% smoking rate and women an 11% rate.

The dramatic drop in smoking rates of those persons aged 65 and over is largely due to the death and disease caused by tobacco. The loss of almost 400,000 persons aged 50 and over annually to smoking-related deaths (almost 300,000 of these deaths are to persons aged 65 and over), accounts for a sizable portion of the percentage drop in smoking rates among persons 65 and over. Many other older persons find a way to stop smoking because their doctors insist that they stop for health reasons.

Even with the reduced smoking rates among older persons, over 4 million persons aged 65 and over are still smokers. And, almost 9 million persons aged 50 to 64 are smokers. Thus, over 13 million Americans aged 50 and over are smokers -- about 27% of all adult smokers.

Quitting Now Improves Health

In spite of all the attention focused on smoking in today's media, many persons are unaware that quitting smoking at any age results in almost immediate improvement in health status. Even persons who have smoked for 30, 40, 50 or more years will begin to feel positive changes in their physical health. For older smokers, there is no better time to quit than now.

* These data are from the Center for Disease Control's (CDC) Smoking-Attributable Mortality, Morbidity and Economic Costs report of August, 1996.

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In July, 1952, Liggett & Myers Tobacco Co. ran an ad in Life magazine, boldly stating The Spotlight's on Chesterfield, and claiming that it was "kept tasty and fresh by pure, costly moistening agents proved by over 40 years of continuous use in U.S.A. tobacco products as entirely safe for use in the mouth...," and that "scientists from leading universities make sure that Chesterfield contains only ingredients that give you the best possible smoke."

Chesterfield adOn March 20, 1997, 47 years later, the spotlight was again on the maker of Chesterfield, as Liggett admitted it had lied repeatedly about the health dangers of tobacco and had for decades intentionally marketed its cigarettes to children as young as 14 years of age. Specifically, Liggett agreed to:

While it's old news to most people that tobacco is addictive, causes cancer and that tobacco companies target children in their marketing, this is the first time any tobacco maker has acknowledged having this information for decades. Thus, all the advertising in the 1940's, '50's, '60's -- the ads that hooked today's elders -- and to the '90's telling smokers that cigarettes were safe -- all these were intentional lies.

In return for these admissions, Liggett settled the 22 pending state lawsuits accusing it and other major tobacco companies of lying about the health effects of tobacco and seeking billions of dollars in damages. The settlement made sense since Liggett tobacco cartoonis the smallest of the five major cigarette makers, and the evidence it has agreed to produce has great potential for helping obtain judgments against other tobacco companies. Liggett's admissions also make further denials by the other tobacco companies seem even more absurd and indefensible to most citizens.

However, in a separate nationwide class action suit settlement, Liggett is seeking blanket immunity from lawsuits by any U.S. resident for any actions Liggett has ever taken to cause harm to such persons through its tobacco products. And, within days of the Liggett settlement, Philip Morris and R.J. Reynolds began "secret talks" with the 22 Attorneys General and the White House to try to reach a settlement providing all tobacco companies with the same blanket immunity from lawsuits. In return, they are offering a financial settlement and agreeing to marketing restrictions which would do little to reduce youth or adult tobacco addiction. Thus, tobacco makers are seeking absolute protection from liability for their intentional and knowing actions in addicting millions of persons to a product, which, if used as directed, kills.

While it's unclear if these "secret" discussions will produce an agreement, any major settlement will require Congressional and Presidential approval. As the persons afflicted by the diseases and death caused by these tobacco companies' products, older persons have a direct interest in any settlement agreements with the tobacco industry -- and an interest in informing Congress and the President of their views.

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Janet Sackman, a former model who appeared as Miss Chesterfield on the Perry Como television show and was a Lucky Strike cover girl in ads that ran in numerous magazines, began to smoke at age 17 when a tobacco executive told her that an aspiring model like her should smoke.

Today, at age 65, Janet Sackman speaks with a voice box. Janet developed lung cancer from years of smoking and had to have her larynx and one third of one lung removed. In recent years Janet has become an activist in the tobacco control movement, speaking frequently to youth with a simple message: "If you smoke, you die. Eventually, it gets you."

Janet Sackman is lucky to still be alive. The family of Jean Connor has only memories, since Jean died two years ago, at the age of 49, of lung cancer after smoking for 33 years. Before she died, Jean made a videotape in which she described the horrors of lung cancer. The tape was so vivid that a Florida judge ruled that it was too emotionally upsetting for a jury to see it without being prejudiced by it.

Janet and Jean's family have one thing in common, besides the horrors of lung cancer: they are both suing the tobacco companies who made the cigarettes they smoked for years. In each case, Janet and Jean are explicit in accusing the tobacco companies of lying about the harmlessness of smoking.

At 68 years of age, Lauretta Bambula had smoked for 43 years and then, six months ago, decided to try to quit. She had tried twice before, in 1982 and 1986, but had not been successful. This time, with the aid of nicotine gum, she had gotten through 5 months without smoking, and then got the shock of her life. She was diagnosed as having lung cancer.

Lauretta is now undergoing radiation treatment, which may have to be followed by chemotherapy. Her doctor can't operate on her because her breathing is so labored due to the years of smoking. She is given a 50-50 chance of living for two more years.

Janet, Jean, Lauretta -- three victims of tobacco. One dead at 49. Two living, but under conditions no one would wish on anyone, even a tobacco executive.

The personal tragedies are unending. Over 400,000 families in the U.S. suffer each year through the tobacco-related deaths of loved ones. The deaths are often lengthy and painful, for both the victim and their families and friends. It's all too easy to be numbed by the figures of 400,000+ deaths annually -- until it's you who is directly affected.

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Cigar advertisementIn the last three years, cigar advertising and sales have risen dramatically, with baby-boomers and older persons as the primary target groups. Led by Cigar Aficionado magazine, this promotional frenzy has featured middle-aged and older movie and sports stars, with a focus on affluence and prestige.

Cigar advertising has been most prominent in up-scale magazines and newspapers, such as The New Yorker and the New York Times, while cigar paraphernalia, such as pocket humidors, cigar cutters and even cigar cuff links, has been featured in Brooks Brothers Clothiers Holiday '96 Catalog.

This targeted niche advertising paid off handsomely. Cigar sales declined steadily from 1970 to 1993, after peaking in 1964 when 9.9 billion cigars were sold in the U.S. This new burst of advertising increased cigar sales by 9.2% from 1994 to 1995. In 1995, about 4 billion cigars were Cigar 

advertisement sold in the U.S., led by sales of premium cigars (at $1 to $20/cigar) with a 28% increase over 1994 sales.

Meanwhile, the pipe tobacco industry is plotting new marketing strategies to cash in on the cigar hype. Sales of pipe tobacco in 1996 in the U.S. were about 7.5 million pounds, a seven-fold decline since 1970. The estimated 3 million U.S. pipe smokers are largely older persons, with half over the age of 46, but they produce sales of $80 million annually.

he boom in non-cigarette tobacco sales reflects the power of focused advertising, but news accounts also suggest that many cigar and pipe smokers mistakenly think that cigars and pipes are safe because the smoke is not supposed to be inhaled.

The Real Facts About Cigars

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The best thing about quitting smoking is that you get immediate positive results -- and, the longer you refrain from smoking, the healthier you get. The following facts are adapted from the Clear Horizons Program materials developed by the Fox Chase Cancer Center in Philadelphia, Pennsylvania (for more information, call (215) 728-2715).

Immediate Benefits of Quitting Smoking:

Longer Term Benefits of Quitting Smoking:

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