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Hunt LJ, Covinsky KE, Cenzer I, Espejo E, Boscardin WJ, Leutwyler H, Lee AK, Cataldo J. The Epidemiology of Smoking in Older Adults: A National Cohort Study. J Gen Intern Med 2023; 38:1697-1704. [PMID: 36538157 PMCID: PMC10212889 DOI: 10.1007/s11606-022-07980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Older smokers account for the greatest tobacco-related morbidity and mortality in the USA, while quitting smoking remains the single most effective preventive health intervention for reducing the risk of smoking-related illness. Yet, knowledge about patterns of smoking and smoking cessation in older adults is lacking. OBJECTIVE Assess trends in prevalence of cigarette smoking between 1998 and 2018 and identify patterns and predictors of smoking cessation in US older adults. DESIGN Retrospective cohort study PARTICIPANTS: Individuals aged 55+ enrolled in the nationally representative Health and Retirement Study, 1998-2018 MAIN MEASURES: Current smoking was assessed with the question: "Do you smoke cigarettes now?" Quitting smoking was defined as having at least two consecutive waves (between 2 and 4 years) in which participants who were current smokers in 1998 reported they were not currently smoking in subsequent waves. KEY RESULTS Age-adjusted smoking prevalence decreased from 15.9% in 1998 (95% confidence interval (CI) 15.2, 16.7) to 11.2% in 2018 (95% CI 10.4, 12.1). Among 2187 current smokers in 1998 (mean age 64, 56% female), 56% of those living to age 90 had a sustained period of smoking cessation. Smoking less than 10 cigarettes/day was strongly associated with an increased likelihood of quitting smoking (subdistribution hazard ratio 2.3; 95% CI 1.9, 2.8), compared to those who smoked more than 20 cigarettes/day. CONCLUSIONS Smoking prevalence among older persons has declined and substantial numbers of older smokers succeed in quitting smoking for a sustained period. These findings highlight the need for continued aggressive efforts at tobacco cessation among older persons.
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Affiliation(s)
- Lauren J Hunt
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way Box 605 N, San Francisco, CA, 94143, USA.
- Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
- Phillip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.
| | - Kenneth E Covinsky
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Irena Cenzer
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Edie Espejo
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- Northern Californian Center for Research and Education, San Francisco, CA, USA
| | - W John Boscardin
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Heather Leutwyler
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way Box 605 N, San Francisco, CA, 94143, USA
| | - Alexandra K Lee
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Janine Cataldo
- Department of Physiological Nursing, University of California, San Francisco, 2 Koret Way Box 605 N, San Francisco, CA, 94143, USA
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Fahey MC, Dahne J, Wahlquist AE, Carpenter MJ. The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit. J Appl Gerontol 2023:7334648231158228. [PMID: 36797652 DOI: 10.1177/07334648231158228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Older adults are a high priority population for smoking cessation. This study observed the influence of older age on the relationship between quitting predictors and cessation. Secondary analysis was conducted of a primary care trial of adults who smoke cigarettes randomized to standard advice to quit or advice plus 2 week supply of nicotine replacement therapy. Logistic regressions assessed interactions of age (<60 vs. ≥ 60 years) by predictors in relation to quit attempts and 6-month cessation controlling for treatment. Predicting quit attempts, there was an interaction of age by motivation (p = .025) and trend of age by nicotine dependence (p = .057). Predicting 6-month cessation, an interaction of age by motivation was observed (p = .020) and a trend of age by dependence (p = .067). For those with high nicotine dependence, older adults had less successful outcomes compared to younger counterparts. Yet among participants unmotivated to quit, older adults had more successful outcomes than those younger.
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Affiliation(s)
- Margaret C Fahey
- Department of Psychiatry and Behavioral Sciences, 2345Medical University of South Carolina(MUSC), Charleston, SC, USA
| | - Jennifer Dahne
- Department of Psychiatry and Behavioral Sciences, 2345Medical University of South Carolina(MUSC), Charleston, SC, USA
| | | | - Mathew J Carpenter
- Department of Psychiatry and Behavioral Sciences, 2345Medical University of South Carolina(MUSC), Charleston, SC, USA
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Jia H, Lubetkin E. Use of a microsimulation method for assessing dynamics of smoking status and gains in life expectancy after quitting in a longitudinal cohort of US older adults. BMJ Open 2022; 12:e062189. [PMID: 36332957 PMCID: PMC9639091 DOI: 10.1136/bmjopen-2022-062189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Previous studies were unable to estimate the dynamics of smoking status in the US elderly general population, and no study has assessed the benefit of quitting in terms of resultant gains in life expectancy. We proposed a novel method to estimate the per cent of quitting in remaining lifetime, successful quitting and relapse, as well as life expectancy by participants' baseline smoking status. DESIGN Longitudinal cohort. SETTING US community-dwelling population. PARTICIPANTS Respondents from the Medicare Health Outcome Survey Cohort 15 (baseline 2012, follow-up 2014). We included respondents who were aged ≥65 years and alive at the baseline and participated in the baseline survey (n=164 597).Primary and secondary outcome measuresAttempt quitting, successful quitting, relapse rates and life expectancy by smoking status at age 65-95 years. RESULTS Among daily smokers aged 65 years, 61% would attempt to quit during their remaining lifetime, and 31% would quit successfully. Among some days smokers aged 65 years, 69% would attempt to quit during their remaining lifetime, and 37% would quit successfully. Among recent ex-smokers aged 65 years, 53% would relapse. Life expectancy at age 65 years was 20.0 (SE=0.27), 17.2 (SE=0.30), 16.2 (SE=0.29) and 15.9 (SE=0.29) years for long time non-smokers, recent ex-smokers, some days smokers and daily smokers, respectively. Although recent ex-smokers had a higher 2-year mortality than current smokers, those who quit up to 77 years (77 years for men and 87 years for women) had a significantly longer (p<0.05) life expectancy. Sensitivity analysis demonstrated that the model assumptions had a relatively small impact on estimates with a maximum relative bias within ±7%. CONCLUSIONS This study provides detailed information regarding the dynamics of smoking status in an understudied and growing population and demonstrates the benefit of smoking cessation on life expectancy. Future research should focus on understanding specific predictors of smoking cessation.
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Affiliation(s)
- Haomiao Jia
- Department of Biostatistics, School of Public Health and School of Nursing, Columbia University, New York, New York, USA
| | - Erica Lubetkin
- Community Health and Social Medicine, The City College of New York, New York, New York, USA
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Fahey MC, Talcott WG, Robinson LA, Mallawaarachchi I, Klesges RC, Little MA. Predictors of Cessation Outcomes Among Older Adult Smokers Enrolled in a Proactive Tobacco Quitline Intervention. J Aging Health 2022; 34:1144-1155. [PMID: 35506995 DOI: 10.1177/08982643221097679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To identify predictors of older adults' likelihood of quitting following engagement in a proactive tobacco quit line. METHODS Older (>60 years) participants (N = 186) enrolled in a four-session quit line with 8-weeks of nicotine replacement therapy reported demographics, beliefs, and information about tobacco use. Point prevalence abstinence was reported at 3 and 12-months. RESULTS In final models, endorsement of quitting to take control of one's life and confidence in quitting were positively associated with 3-month cessation (OR = 1.74, 95% CI = 1.16, 2.62; OR = 1.75, 95% CI = 1.21, 2.52, respectively). At 12 months, stronger endorsement of quitting to take control of one's life and decreased nicotine dependence were associated with higher cessation (OR = 1.51, 95% CI = 1.05, 2.17; OR = 0.84, 95% CI = 0.71,0.99, respectively). DISCUSSION For tobacco cessation among older adults, programs should provide additional support to those with higher nicotine dependence, promote quitting self-efficacy, and encourage quitting as means to gain control of life and health.
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Affiliation(s)
- Margaret C Fahey
- 5415Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Wayne G Talcott
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
- 438578Joint Base San Antonio-Lackland, San Antonio, TX, USA
| | - Leslie A Robinson
- 5415Department of Psychology, The University of Memphis, Memphis, TN, USA
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
| | - Robert C Klesges
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
- 438578Joint Base San Antonio-Lackland, San Antonio, TX, USA
| | - Melissa A Little
- Department of Public Health Sciences, 2358University of Virginia, Charlottesville, VA, USA
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Shtaiwi A, Siddiqui F, Kanaan M, Siddiqi K. What factors are associated with waterpipe smoking cessation? A secondary data analysis. Nicotine Tob Res 2021; 24:581-589. [PMID: 34751780 DOI: 10.1093/ntr/ntab234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Waterpipe smoking is gaining popularity and becoming a major global public health concern. An understanding of factors that predict waterpipe smoking cessation is necessary for targeting tobacco control efforts. METHODS This is a secondary data analysis of a randomised controlled-trial comparing the efficacy of varenicline against placebo in helping waterpipe smokers to quit. A total of 510 adult daily waterpipe smokers were recruited to the trial in 2016. Logistic regression models were applied to assess factors (i.e., demographic, environmental, behavioural, and physiological) associated with primary outcome (waterpipe smoking cessation) and secondary outcomes (waterpipe cessation alongside abstinence from cigarette and short-term and long-term waterpipe smoking cessation). Cessation was defined as 7-day point prevalence abstinence from smoking reported at 5,12, and/or 25 weeks follow ups. RESULTS Over a period of six months, 189 (39.2%) participants abstained from waterpipe smoking for at least one week. Being male (adjusted odds ratio (aOR):2.99 (95%CI:1.47-6.08)), dual smoker (waterpipe and cigarettes) (aOR:2.98 (95%CI:1.87-4.74)), more withdrawal symptoms measured by the Mood and Physical Symptoms Scale (aOR:1.08 (95%CI:1.02-1.13)), less nicotine dependency measured by Lebanon Waterpipe Dependency Scale (aOR:0.90 (95%CI:0.85-0.96)), having history of quit attempt (aOR:2.14 (95%CI:1.16-3.96)), smoking restriction in the house (aOR:2.69 (95%CI:1.01-7.14)), and not sharing waterpipe with others (aOR:2.72 (95%CI:1.31-5.66)) predicted waterpipe smoking cessation. CONCLUSIONS In addition to nicotine dependency, social factors such as home restrictions on smoking, and not sharing waterpipe were identified as predictors of waterpipe smoking cessation. To help waterpipe smokers quit, social environment may be just as or even more important than well-known physical and psychological factors. IMPLICATIONS A range of factors, predominantly social factors play a significant role in facilitating or deterring waterpipe smokers from quitting smoking. Our findings suggest that interventions that focus on social as well as physical/psychological factors may encourage waterpipe smokers in achieving abstinence.
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Affiliation(s)
| | - Faraz Siddiqui
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Mona Kanaan
- Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York YO10 5DD, UK
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Lim HK, Park YS, Kim JH, Kim JH. Factors that Predict Smoking Cessation among Older Koreans: Based on the Korea National Health and Nutrition Examination Survey 2016-2018. Korean J Fam Med 2021; 42:363-368. [PMID: 34607411 PMCID: PMC8490175 DOI: 10.4082/kjfm.20.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Background Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans. Methods We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans. Results Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70). Conclusion Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.
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Affiliation(s)
- Han Kyul Lim
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Yong Soon Park
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jeong Hyeon Kim
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Jeong Hyun Kim
- Department of Family Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
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He H, Lu H, Liu S, Cai J, Tang X, Mo C, Xu X, Chen Q, Xu M, Nong C, Liu Q, Zhang J, Qin J, Zhang Z. Effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in southern China. J Orthop Surg Res 2021; 16:372. [PMID: 34116692 PMCID: PMC8194121 DOI: 10.1186/s13018-021-02522-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/03/2021] [Indexed: 08/30/2023] Open
Abstract
Background Hand grip strength is a complex phenotype. The current study aimed to identify the effects of the association between APOE rs405509 polymorphisms and gene-environment interactions on hand grip strength among middle-aged and elderly people in a rural population in Gongcheng, southern China. Methods APOE rs405509 polymorphisms in 1724 participants (695 men and 1029 women, aged 45–97 years old) were genotyped using the Sequenom MassARRAY platform. Statistical analysis was conducted using SPSS 21.0 and Plink 1.90. Results The APOE rs405509 G allele was associated with lower hand grip strength in all participants (β = −1.04, P value <0.001), and the correlation seemed to be even stronger among women. A significant gene-environment interaction was observed between APOE rs405509 and smoking, especially in men. The hand grip strength of male smokers carrying the GG genotype was significantly higher than that of nonsmokers (P value = 0.004). Conclusions APOE rs405509 polymorphisms might be genetic factors that affect hand grip strength in a rural population in Gongcheng, southern China. The APOE rs405509-smoking interaction has an impact on hand grip strength.
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Affiliation(s)
- Haoyu He
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Quality Management, The Affiliated Hospital of Stomatology, Guangxi Medical University, 10 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Huaxiang Lu
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China.,Department of Guangxi Science and Technology Major Project, Guangxi Zhuang Autonomous Region Center for Diseases Control and Prevention, 18 Jinzhou Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Shuzhen Liu
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiansheng Cai
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xu Tang
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Chunbao Mo
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Xia Xu
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Quanhui Chen
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Min Xu
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Chuntao Nong
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Qiumei Liu
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Junling Zhang
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jian Qin
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China.
| | - Zhiyong Zhang
- School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, China. .,School of Public Health, Guilin Medical University, 20 Lequn Road, Guilin, Guangxi Zhuang Autonomous Region, China.
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Farmer AY, Wang Y, Peterson NA, Borys S, Hallcom DK. Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis. J Gerontol B Psychol Sci Soc Sci 2021; 77:919-929. [PMID: 33959768 DOI: 10.1093/geronb/gbab078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to determine substance use among older adults based upon their social isolation and loneliness profiles. METHODS Data were derived from the New Jersey Older Adult Survey on Drug Use and Health (OASDUH). Latent profile Analysis (LPA) was used to determine the profiles of older adults (N = 801) based on five dimensions of social isolation and loneliness. Logistic and generalized ordered logistic regressions were conducted to assess the relationship between the latent profiles and substance use. RESULTS LPA identified five social isolation/loneliness profiles. The "connected and active" group had the lowest odds of cigarette use. The "alone but not lonely" group had the highest odds of cigarette use, alcohol use, and high-risk drinking. The "alone and lonely" group had the highest odds of non-medical drug use. DISCUSSION In working with older adults who are using substances, it is important to inquire about their social isolation and loneliness. Cognitive behavioral therapy for the "alone and lonely" group may be beneficial, as it has been deemed effective in reducing loneliness and enhancing social network.
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Affiliation(s)
- Antoinette Y Farmer
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Yuqi Wang
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - N Andrew Peterson
- The State University of New Jersey, School of Social Work, Faculty Affiliate, Center for Prevention Science, Faculty Affiliate, Center for Violence Against Women and Children, 536 George Street, Room 114, New Brunswick, New Jersey
| | - Suzanne Borys
- Assistant Division Director, Office of Planning, Research, Evaluation, and Prevention, Division of Mental Health and Addiction Services, 120 South Stockton Street, P.O, Box 362, Trenton, New Jersey
| | - Donald K Hallcom
- Director of Prevention and Early Intervention, New Jersey Department of Health, Division of Mental Health and Addiction Services, 120 South Stockton Street, PO Box 362, Trenton, NJ
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Chang PY, Shiu MN, Yuan YT, Chang HC, Su PY, Lan TH. Comparative Effectiveness of Varenicline and Nicotine Replacement Therapy for Smoking Cessation in Older and Younger Smokers: A Prospective Cohort in Taiwan. Nicotine Tob Res 2020; 21:149-155. [PMID: 29294121 PMCID: PMC6319447 DOI: 10.1093/ntr/ntx275] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 12/22/2017] [Indexed: 01/22/2023]
Abstract
Introduction The effectiveness of varenicline compared with nicotine replacement therapy (NRT) in achieving smoking cessation in older smokers has not been investigated. This study prospectively compared the effectiveness of varenicline relative to NRT in smokers aged 25–54 years and separately in smokers aged 55 years or older. Methods Among 13 397 smokers participating in the Smoking Cessation Program in Taiwan, 2012–2015, 6336 (19.2%, aged ≥55) received varenicline and 7061 received NRT patch or gum (23.2%, aged ≥55). Participants self-reported smoking behaviors by phone interview after 6 months. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) for 7-day, 1-month, and 6-month point-prevalence abstinence. Age-specific models adjusted for sex, education, marital status, smoke-years, nicotine dependence, medical institution, clinic visit number, and duration of medication received. Results Among smokers aged 25–54 years, varenicline users had a greater point-prevalence abstinence than NRT users (e.g., 7-day point-prevalence: 34.0% vs. 23.5%), with adjusted OR ranging from 1.23 (CI: 1.09–1.39; 6-month point-prevalence) to 1.37 (CI: 1.24–1.50; 1-month point-prevalence). Among smokers aged 55 years or older, point-prevalence was similar for varenicline and NRT users (e.g., 7-day point-prevalence: 32.3% vs. 33.1%), and ORs did not suggest that varenicline has greater effectiveness than NRT. Sex and level of nicotine dependence did not modify the age-specific effectiveness of varenicline relative to NRT. Conclusions Varenicline did not offer greater effectiveness in achieving abstinence than NRT for smokers 55 years or older, whereas it was more effective than NRT in smokers aged 25–54 years. These findings highlighted the need for age-specific approaches for effective tobacco control. Implications In this prospective investigation of a national cohort, older smokers (aged ≥55 years) who received varenicline did not have a greater point-prevalence abstinence after 6 months compared with those who used NRT patch or gum. Younger smokers (aged 25–54 years) who received varenicline had a greater likelihood of abstinence than NRT users. Sex and nicotine dependence did not modify the age-specific effectiveness of varenicline relative to NRT patch or gum. Age-appropriate approaches for effective tobacco control are needed.
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Affiliation(s)
- Po-Yin Chang
- Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, USA
| | - Ming-Neng Shiu
- Faculty of Pharmacy, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Yuan
- Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Cardiovascular Surgery, Cheng-Hsin General Hospital, Taipei, Taiwan
| | - Hui-Chin Chang
- Institute of Health and Welfare Policy, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Yu Su
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
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Sarkar S, Chawla N, Dayal P. Smoking and tobacco use cessation in the elderly. JOURNAL OF GERIATRIC MENTAL HEALTH 2020. [DOI: 10.4103/jgmh.jgmh_23_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chang CP, Huang WH, You CH, Hwang LC, Lu IJ, Chan HL. Factors Correlated with Smoking Cessation Success in Older Adults: A Retrospective Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3462. [PMID: 31540355 PMCID: PMC6766016 DOI: 10.3390/ijerph16183462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 01/02/2023]
Abstract
Smoking cessation in the elderly is very important. This study aims to explore the success rate of smoking cessation in the elderly and the factors that predict the success of smoking cessation. We collected data from smokers ≥60 years who visited a medical center in Taiwan during 2017. All patients were prescribed either varenicline or nicotine replacement therapy (NRT) for smoking cessation. The participants were asked about their smoking status after treatment. In total, 129 participants were enrolled. The three- or six-month point abstinence rate was 48.1%. No significant difference was found among baseline characteristics (including age, gender, underlying diseases, smoking duration, daily consumption amount of cigarette, carbon monoxide concentration, Fagerström test for nicotine dependence scores, and treatment method) between quitters and non-quitters, except for the type of medication used. The proportion of quitters using varenicline was significantly higher than that of non-quitters. Multivariate regression analyses showed that the patients who received varenicline were 3.22 times more likely to quit smoking than those who received NRT. Therefore, we suggest that varenicline use may help in smoking cessation in older adults, compared to NRT. Other baseline characteristics may not affect the success rate of smoking cessation in this population.
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Affiliation(s)
- Chih-Po Chang
- Department of Family Medicine, Mackay Memorial Hospital, Taipei 106, Taiwan; (C.-P.C.); (W.-H.H.)
| | - Wei-Hsin Huang
- Department of Family Medicine, Mackay Memorial Hospital, Taipei 106, Taiwan; (C.-P.C.); (W.-H.H.)
| | - Ching-Hui You
- Department of Family Medicine, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taipei 116, Taiwan;
| | - Lee-Ching Hwang
- Department of Family Medicine, Mackay Memorial Hospital, Taipei 106, Taiwan; (C.-P.C.); (W.-H.H.)
- Mackay Medical College, New Taipei City 252, Taiwan
| | - I-Jung Lu
- Department of Leisure and Recreation Management, Chihlee University of Technology, New Taipei City 252, Taiwan;
| | - Hsin-Lung Chan
- Department of Family Medicine, Mackay Memorial Hospital, Taipei 106, Taiwan; (C.-P.C.); (W.-H.H.)
- Mackay Medical College, New Taipei City 252, Taiwan
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Kulak JA, LaValley S. Cigarette use and smoking beliefs among older Americans: findings from a nationally representative survey. J Addict Dis 2018; 37:46-54. [PMID: 30574840 DOI: 10.1080/10550887.2018.1521255] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Between 2005 and 2015, the prevalence of smoking among US adults has decreased for all age subgroups, except those aged 65 and older. Aim: In order to identify potential correlates of smoking behaviors in older adults, this research examined associations between age, smoking beliefs, and quitline utilization. Methods: Self-reported, nationally representative data from the Health Information National Trends Survey 2015 cycle (HINTS-FDA) were used (n = 3738). Multivariable logistic regression analyses examined associations between sociodemographic characteristics and beliefs about smoking behaviors. All analyses were conducted with jackknife estimation using sampling weights. Results: Among all survey respondents, 10.5% of those aged 65+ were current smokers (smoked 100 lifetime cigarettes and currently smoked every day or some days). These older adults, compared to those aged 18-29 years, had significantly higher odds of agreeing that smoking behavior is something one can do little to change (AOR = 1.89, 95% CI =1.08, 3.28) and agreeing that nicotine is the substance that causes cancer (AOR = 3.93, 95% CI = 2.17, 7.12). Post hoc analyses compared midlife adults (ages 50-64) with older adults (ages 65+), and indicated older adults had lower odds of having used a quitline/smoking cessation website (AOR = 0.36, 95% CI = 0.14, 0.94, p = 0.04) compared to their midlife peers. Discussion: US adults aged 65 and older hold erroneous beliefs about cigarette smoking behaviors and are less likely to utilize quitline supports. This may be contributing to the stagnant smoking rates among older adults. Smoking cessation efforts targeting older adult Americans are critical in order to stem tobacco use among all Americans.
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Affiliation(s)
- Jessica A Kulak
- a Department of Family Medicine , Primary Care Research Institute , University at Buffalo , Buffalo , NY , USA
| | - Susan LaValley
- a Department of Family Medicine , Primary Care Research Institute , University at Buffalo , Buffalo , NY , USA
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van Beers M, Janssen DJA, Gosker HR, Schols AMWJ. Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions. Expert Rev Respir Med 2018; 12:1061-1074. [DOI: 10.1080/17476348.2018.1533405] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Martijn van Beers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Daisy J. A. Janssen
- Department of Research & Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Centre of Expertise for Palliative Care, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Harry R. Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Annemie M. W. J. Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
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