Short communicationPsychosocial correlates of smoking cessation among elderly ever-smokers in the United States
Introduction
Cigarette smoking remains the number one preventable cause of morbidity and mortality among older persons in the United States (Center for Disease and Control and Prevention [CDC], 1993). Yet, approximately 12% of Americans aged 65 and older continue to smoke, and the rate of decline in smoking is slower among older adults than among younger adults (Husten et al., 1997). The perpetuation of smoking behavior among the elderly is often attributed to misinformation, erroneous belief systems and fatalism, habituation, the need to relieve stress, physical pleasure, and nicotine addiction Appel & Aldrich, 2003, Ossip-Klein et al., 1999. A few studies have attempted to disentangle the underlying attributes that account for smoking cessation among older persons Husten et al., 1997, Kaplan et al., 2002, Williams et al., 2001 and found that younger age, limited educational attainment, being employed, living with another smoker, having no regular physician, infrequent religious activities, and the presence of psychological distress were independent determinants of current smoking. However, methodological constraints of these studies, such as heterogeneity of study sample and variables analyzed, have limited our understanding of psychosocial correlates of smoking behavior among older persons, warranting further exploration of the relationship between psychological distress and smoking cessation among elderly. Drawing on aspects of the social cognitive theory (SCT; Bandura, 1986), the aim of this study was to assess the relationship between smoking cessation and psychosocial factors among older ever-smokers.
Section snippets
Sample and variables
The data were from the 2000 National Health Interview Survey (NHIS) sample Adult Core questionnaire and Cancer Control module (N=32,374). With appropriate sampling weights, the data are representative of the entire U.S. adult population; the methodology has been described in detail elsewhere (Botman, Moore, Moriarity, & Parsons, 2000). Respondents who were older than 60 years old and ever-smokers (N=3170) were included in the analysis.
The dependent variable was “former smokers.” Smokers were
Results
Among people older than 60 years (n=8179), the prevalence of current smokers was 13.9% for males and 12.4% for females, in which the overwhelming majority were daily smokers (table not shown). Of those who were ever-smokers (n=3170), 892 were classified as current smokers, 2288 as former smokers. As compared with current smokers, former smokers were disproportionately comprised of older adults, male, higher education, higher income, married, unemployed or nonworker, and had a regular source for
Discussion
This study found significant differences in psychological profiles between former versus current smokers. Consistent with prior studies about older populations and general populations Andreski & Breslau, 1993, Brown et al., 2000, Green et al., 2003, Kaplan et al., 2002, Kendler et al., 1993, McCaffery et al., 2003, Son et al., 1997, current smokers were significantly more likely to exhibit psychological distress than do former smokers. Smoking may be a way of coping with psychological distress
Acknowledgements
Dr. Honda is supported by a postdoctoral fellowship from the National Cancer Institute (CA09529).
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