Role of New Diagnosis, Social Isolation, and Depression in Older Adults' Smoking Cessation

Abstract

Purpose of the study: Though older adults smoke at a lower rate than younger adults, cessation can be difficult, especially after years of smoking. This paper examined the influence of a diagnosis of chronic illness, social isolation, and depression on smoking cessation among the most recent cohort of older smokers who were representative of U.S. Medicare beneficiaries.

Design and methods: We used data from the 2011 (T1) and 2012 (T2) interview waves of the U.S. National Health and Aging Trends Study. Multivariate regression models examined correlates of T1 smoking status (never smoker, former smoker, and current smoker; n = 6,680) and predictors of T2 smoking status among T1 smokers (quit smoking vs. continued smoking; n = 412).

Results: At T1, 8.8%, 44.7%, and 46.5% of the sample, respectively, were current, former, and never smokers. Current smokers had lower socioeconomic status, were more socially isolated, and had higher depressive symptoms than never smokers. At T2, 88.9% of T1 smokers continued smoking and 11.1% no longer smoked. The odds of smoking cessation increased with a new diagnosis of chronic illness since T1 and decreased with a higher number of cigarettes smoked at T1. Social isolation at T1 increased the odds of smoking cessation, but depressive symptoms at T1 were not a significant factor.

Implications: Heavy-smoking older adults may require extended pharmachotherapy and counseling. As newly diagnosed health problems can be a trigger for smoking cessation, health care providers can motivate and help older adults quit (or reduce) smoking as an integral part of their practices.

Keywords: Depression; New diagnosis; Older adults; Smoking cessation.