UCSF

Age Related Differences in Smoking Cessation Outcomes

For Women Hospitalized With Cardiovascular Disease

Daniel M. Doolan RN, MSN

ABSTRACT

Background: Smoking is the number one preventable cause of death and disease. Smoking cessation has immediate health benefits, even among those who have smoked for many years. Despite the known risks of smoking and the benefits of cessation, the efficacy of smoking cessation interventions among older adults and women has received limited research attention.

Objectives: To determine if there are age related clinical and demographic differences between older versus younger women with cardiovascular disease who smoke, and to determine if these two groups differ in their smoking cessation outcomes.

Method: An existing data set from The Women's Initiative for Nonsmoking (WINS) is used for this study. The original WINS study was an RCT that tested the efficacy of a smoking cessation intervention for Bay Area women hospitalized with cardiovascular disease. The current study compares WINS participants who were 62 and older with those younger than 62.

Results: The sample (n=277) contained 136 older smokers and 141 younger smokers. Older smokers were significantly more likely to be living alone, widowed, poorer, retired, have hypertension, and have multiple comorbidities. Older women were significantly less likely to be obese. Stanford Dependence Index scores showed older women had significantly lower levels of nicotine addiction. Older women were significantly less likely to have one or more housemates who smoke. At the 6 month follow-up, 52.1% of older smokers had quit smoking compared with 40.6% of younger smokers. At the 12 month follow-up, 52.0% of older smokers had quit smoking compared with 38.1% of younger smokers. The difference at 12 months was statistically significant. A Kaplan-Meier Survival Analysis found older women were significantly less likely to relapse over 12 months than younger women.

Discussion: Older women with cardiovascular disease demonstrated extremely high rates of smoking cessation, higher even than younger women with cardiovascular disease. Further research is needed to determine how to optimize smoking cessation rates for older smokers. Clinicians should be sure to also include older smokers in smoking assessments and smoking cessation interventions.