|TOBACCO & THE ELDERLY NOTES|
|The Center for Social Gerontology
Tobacco & the Elderly Project
|2307 Shelby Avenue, Ann Arbor, Michigan 48103
Tel: 734-665-1126 Fax: 734-665-2701
OLDER PERSONS -- TOBACCO'S FORGOTTEN VICTIMS
- Posters Highlight Tobacco's Impact on Older Persons
- Evidence Mounts of Tobacco's Wide-Ranging Dangers
- Oral & Throat Cancer Attack Middle-Aged & Older Persons; Smoking is Primary Risk Factor
- Heavy Smokers Vastly Underestimate Risk of Premature Death
- Tobacco-Related Diseases Will Cost Medicare $800 BIllion Over the Next 20 Years
- Athletes Prevalent in Tobacco Ads in 1930s to 1970s When Today's Elders Started Smoking
POSTERS HIGHLIGHT TOBACCO'S IMPACT ON OLDER AMERICANS
Older Americans are the forgotten victims of tobacco-related death and disease. While enormous attention has been focused on tobacco industry marketing to youth -- and rightly so -- the suffering of older persons from tobacco-related diseases has received virtually no attention by the media, researchers, service providers or policymakers.
Comments such as, "someone who has smoked for 50 years can't or won't change," or, "why bother trying to get them to quit, they won't live much longer," indicate that ageism is part of the reason that older smokers have been ignored and neglected. Whether ageism is the cause of the lack of attention to older smokers and older victims of second-hand smoke or whether there are other reasons, the time has come for these attitudes to change.
Yet, many Americans are unaware of both the growth of the aging population and the enormous toll that tobacco-related diseases take on older persons. To begin to remedy this void of information, The Center for Social Gerontology (TCSG), with support from the Michigan Department of Community Health, has embarked on a campaign to raise the consciousness of people of all ages about the impact of tobacco-related diseases on older Americans.
The dissemination of TCSG's Tobacco & the Elderly Notes newsletter and other publications has begun to focus attention on this issue. TCSG's web site at http://www.tcsg.org includes a special section on Tobacco & the Elderly issues, including copies of our newsletter, to provide easy and broad access to this information.
Now, TCSG has created and is disseminating two posters for posting at Senior Centers, meals sites for the elderly, health centers, meeting facilities, recreation centers, housing facilities for elders, educational facilities, and other facilities serving old and young.
These posters highlight two basic themes: first, older Americans are the ones who suffer from the disease and death caused by tobacco use; and second, not quitting smoking can shorten a persons life by 12 to 15 years, thereby eliminating any retirement years. The message of these posters is that older Americans must be included in any efforts to reduce tobacco use, to create smoke-free environments and to remedy the health damage caused by tobacco use. For more information on the posters (and bigger pictures of the posters themselves), click here.
EVIDENCE MOUNTS OF TOBACCO'S WIDE-RANGINGDANGERS
Hearing Loss Linked to Smoking
"Current cigarette smokers were 1.7 times as likely to have hearing loss as nonsmokers," according to a study of over 3,700 adults aged 48 to 92 years, which was published in the June 3, 1998 Journal of the American Medical Association.
The research also showed that nonsmokers living with a smoker were more likely to have hearing loss than those who were not exposed to a household member who smoked. This finding of an association between environmental tobacco smoke (ETS) and hearing loss is consistent with research showing a relation of ETS and hearing sensitivity in children.
Hearing loss is estimated to affect 30% to 35% of adults aged 65 to 75 in the U.S. The above research, together with other studies, suggests that cigarette smoking may have an affect on hearing loss, much as it is a well-known risk factor for other chronic diseases. This would suggest that quitting smoking and avoiding ETS may prevent or delay age-related declines in hearing sensitivity.
Smoking May Hasten Mental Decline
Smoking after age 65 may hasten mental decline, according to a study that looked at over 9,200 non-demented people aged 65 and over. The research by Laura Launer of Erasmus University Medical School in Rotterdam, Netherlands was released in April, 1998 at the American Academy of Neurology annual meeting.
The study linked the mental decline of older smokers with "silent strokes," which are very small strokes that go unnoticed by their victims. The study stated that smoking is already a known risk factor for stroke, which is a loss of blood flow that damages the brain.
The research tested smokers, former smokers and never smokers on such things as shot-term memory, time and place orientation, attention and calculation. Within a two year time span, all three groups of persons aged 65 and over experienced a decline in cognitive abilities, but the study found that older smokers had a significantly greater decline. Former smokers had a slightly more rapid decline than never-smokers, but the difference was not significant.
The study adjusted for other factors that might affect cognitive function, such as age, education and history of stroke, but did not take into account such things as alcohol consumption, how heavily people smoked, how long former smokers smoked and when they quit. Researchers know that alcohol and diet are important factors in cognitive function. Thus, more research is needed to see if Launer's findings will be confirmed by others. However, Launer's study raises one more concern about smoking.
Smoking and Alzheimer's Linked
Smokers are more than twice as likely as non-smokers to develop dementia and Alzheimer's disease, according to a study published in June, 1998 in The Lancet, an international medical journal.
The study, by scientists from a number of Dutch universities, is one of the largest to investigate the link between smoking and Alzheimer's. The study of nearly 7,000 people aged over 55 found smoking was a strong risk factor for both men and women.
The researchers found smoking to be a risk for dementia even when they adjusted their analysis for variables such as alcohol intake and educational levels. Prior research has shown that smoking damages the small blood vessels around the body.
Alzheimer's disease is known as a disease of old age, but it can occur in people in their 50's. It is characterized by memory loss and reduced ability to think and organize. At this time, researchers tend to believe that genetic predisposition is the key to the onset of Alzheimer's, but this new research finds that smoking is also a risk factor.
Dr. Robert Burton of the Anti-Cancer Council of Victoria, Australia said people needed to be warned about the link between smoking and dementia, saying, "Not only are smokers giving up quantity of life, they're giving up quality of life. They're giving up the thing that really makes you human: the ability to think." Dr. Burton added, "Every cigarette actually does do a little bit of damage. When you accumulate enough damage, the tobacco fairy taps you on the shoulder and says it's your time to go."
THROAT CANCER ATTACK MIDDLE-AGED
& OLDER PERSONS; SMOKING IS PRIMARY RISK FACTOR
The Oral & Throat Cancer Threat
In 1998, over 30,000 Americans will be diagnosed with oral and throat cancer. Approximately 8,000 deaths will result, with about 5,200 men and 2,800 woman succumbing to these cancers. These and the findings below were reported by the U.S. Centers for Disease Control & Prevention (CDC) in an August 28, 1998 report titled Preventing and Controlling Oral and Pharyngeal Cancer.
Ninety-five percent of cases of oral and throat cancer occur in persons aged 40 and over; and the average age at diagnosis is 60 years. Oral cancer (i.e., cancer of the lip, tongue, floor of the mouth, palate, gingiva and alveolar mucosa, buccal mucosa, or oropharynx) accounts for 2% to 4% of cancers diagnosed each year in the United States, with about 2/3 of the cancers occurring in the oral cavity and 1/3 in the throat.
Blacks have higher oral cancer incidence and mortality rates than whites. Black males have an incidence rate 1.6 times higher than white males, and a mortality rate 2.5 times higher; black females have a slightly higher incidence and mortality rate than white females.
Smoking (cigarette, pipe or cigar), particularly when combined with heavy alcohol consumption, is the primary risk factor for approximately 75% of oral cancers in the U.S., according to the CDC. Thus, oral cancer is a very preventable disease, if one simply doesn't smoke.
Persons who have oral cancer often develop multiple primary lesions and second primary tumors. If oral cancer is detected early, it may still be localized and thereby more susceptible to successful treatment. The 5-year survival rate for persons having oral cancer is 81% for those diagnosed with localized cancer; 42% for patients with regional disease; and just 17% for those with distant metastases. Thus, early diagnosis of oral cancer is crucial to improving survival rates and reducing the risk of death.
Former Beatle Battles Throat Cancer from Smoking
In June, George Harrison, the former Beatle, divulged he had been fighting throat cancer for almost a year. He noticed a lump on his neck in July, 1997 and had surgery in August to remove the cancerous lump, followed by two courses of radiation therapy. In January and May of 1998 he was tested and found to be free of any further cancer.
"I'm not going to die on you folks just yet," said the 54 year old Harrison. "Luckily for me, they found that this nodule was more of a warning than anything else. There are many different types of cancerous cells, and this was a very basic type."
"I got it purely from smoking. I gave up cigarettes many years ago but had started again for a while and then stopped in 1997," said Harrison. He said the battle with throat cancer made clear to him how fragile life was, saying, "it reminds you that anything can happen. That's the nature of life."
Editor's note: It also reminds one how important prevention is -- both annual physical exams and stopping smoking.
RISK OF PREMATURE DEATH
People who smoke heavily -- one or more packs of cigarettes a day -- vastly underestimate their risk of premature death, according to research published in the American Journal of Public Health in May, 1997.
Whereas former smokers and light smokers were fairly accurate in predicting their chances of reaching age 75 -- about the average longevity for males today and a little less than the average for females -- heavy smokers were quite inaccurate. Men aged 50 to 62 who were heavy smokers estimated they had a 50-50 chance of reaching age 75, whereas mortality rates showed they had only about a 25% chance of living to age 75. Heavy smoking women were almost as unrealistic in their estimates of reaching age 75.
This overly optimistic, unrealistic view of their chances of living long enough to enjoy retirement may result in their being less motivated to quit smoking.
Yet, research shows that quitting smoking at any age, including after 65, improves health. A recent study in Spain, reported in the American Journal of Epidemiology in September, 1998, showed that quitting smoking, even after 65, can increase longevity.
Unfortunately, too many smokers have an unrealistic view of their likelihood of surviving the dangers of smoking. We at The Center for Social Gerontology (TCSG) refer to this as the "George Burns syndrome," that is, a belief that if George Burns could live to 100 years while still smoking cigars, they can too even if they smoke.
The "George Burns syndrome" undoubtedly operates because only about 1 in 3 smokers die prematurely from smoking. However, the persons who die prematurely have a life span that is 12 to 15 years less than it would otherwise be if they had not smoked. We at TCSG refer to taking this risk of continuing to smoke as "Smoker's Russian Roulette" because it is akin to putting 2 bullets in the 6 chambers of a pistol, putting the gun to your head and pulling the trigger. The chance of surviving is only 1 in 3.
Since we know that quitting smoking can improve the chances of living to enjoy a longer and healthier life, isn't it time to try to quit? When one works all those years to reach retirement, living to enjoy it makes a lot of sense.
DISEASES WILL COST
$800 BILLION OVER THE NEXT 20 YEARS*
*Califano, J., "The Impact of Substance Abuse," Tobacco Control, Vol. 4, Supplement 2, Autumn, 1995, p. S20.
ATHLETES PREVALENT IN TOBACCO ADS IN 1930s TO 1970s WHEN TODAY'S ELDERS STARTED SMOKING
Today's older Americans -- those persons aged 50 and over -- were born before 1948. Their most formative years were during the period leading up to their early twenties, that is, the 1930s to the early 1970s. This was the period when tobacco advertising also had its strongest effect, since research has shown that 90% of current smokers started when they were under 18 years of age.
Tobacco advertising has long utilized sports, movie, radio, TV and other celebrities to glorify smoking and chewing to attract new generations of smokers to replace those who quit or die. Since the 1930s, athletes have been among the most prominent celebrities hired to promote tobacco products.
The ads on this page illustrate the stature of the sports celebrities hired to hawk cigarettes and the breadth of the sports covered -- baseball, football, golf, basketball, rodeo -- and that doesn't include ads using tennis and racing stars. One of the most successful sports/tobacco ventures was the Virginia Slims tennis tour which targeted young girls.
Baseball great Joe DiMaggio was in ads in the 1930s and 1940s; football (and now TV) star Frank Gifford was in 1960s ads, as was Boston Celtics basketball Hall of Famer Bob Cousy; golf great Arnold Palmer advertised L&M cigarettes and was so well known the ad didn't even give his name. In 1963, the tobacco industry adopted a "code of advertising ethics" which prohibited use of celebrities and athletes to promote smoking; this reduced, but did not eliminate such ads, as the tobacco industry became more clever in circumventing the ban, as ads appeared on race cars and their driver's helmets, etc. And, since the ban didn't apply to chewing tobacco, football and rodeo great Walt Garrison was featured in a 1975 ad promoting Skoal and Copenhagen.
Today, most athletes refuse to allow themselves to be used to promote tobacco products. However, some athletes still allow themselves to be used to glorify tobacco products, such as cigars; see Sports Illustrated cover with football great Mike Ditka (inside, Ditka's wife Diana was pictured smoking a cigar also). As athletes realize how they are being manipulated by the tobacco industry to influence kids to smoke, we should see an end to such advertising; but, it's effects on today's older Americans is seen every day in hospitals and long term care facilities.