Cigarette use and smoking beliefs among older Americans: findings from a nationally representative survey*

Peripheral Artery Disease

“…Risk factors of PAD in older populations include cigarette smoking and diabetes. A recent report indicates that adults aged over 65 generally hold erroneous beliefs about cigarette smoking behaviors and are less unwilling to seek for cigarette cessation supports (Kulak and LaValley 2018). Cigarette smoking, though its mechanism in promoting the development and progression of PAD is not fully elucidated, may involve endothelial damage, arterial smooth muscle proliferation, inflammatory response, and other metabolic dysfunctions (Chelland Campbell et al 2008;Fowkes et al 2013).…”

Double Whammy for Older Smokers: Marginalized by Tobacco Control and Valued by the Tobacco Industry

“…This is a critical knowledge gap, older smokers are at greatest risk of smoking-related morbidity and mortality (Zbikowski et al, 2012). In one of the few recent studies, older smokers were compared to those younger, and the findings showed that older smokers were misinformed about the role of nicotine in smoking, more likely to agree that smoking is "something basic about a person that can't be changed," and less likely to access a telephone or Internet quitline (Kulak & LaValley, 2018). Quitlines have been found to be effective, yet, because of a lack of awareness they are underutilized by older smokers (Kulak & LaValley, 2018).…”

“…In the United States older smokers account for the greatest tobacco-related morbidity and mortality and subsequent health care costs (Andrews, Heath, & Graham-Garcia, 2004; Kulak & LaValley, 2018). Older smokers are at greater risk of nicotine interactions, namely, increased drug metabolism (Kulak & LaValley, 2018). As a result, blood levels of drugs commonly used by older adults are lowered (e.g., beta blockers; Andrews et al, 2004).…”

“…When compared with younger smokers, older smokers are more likely to be non-White, lower socioeconomic status (SES), have a mental illness, have several comorbidities and at least one disability (Schoeni, Martin, Andreski, & Freedman, 2005), yet, they are not considered a marginalized group (Cataldo, Hunter, Petersen, & Sheon, 2015; Dawel & Antsey, 2011). In addition, older smokers are less likely than younger smokers to believe illness is a consequence of smoking (Kulak & LaValley, 2018; Orleans, Jepson, Resch, & Rimer, 1994; Poland et al, 2000), are more likely to blame themselves for their smoking behaviors, and are less likely to be treated for tobacco use (Doescher & Saver, 2000; Ellerbeck, Ahluwalia, Jolicoeur, Gladden, & Mosier, 2001; Houston et al, 2005). Common health myths related to older smokers have contributed to their vulnerability, myths such as smoking is a choice rather than an addiction (Balbach, Smith, & Malone, 2006), “low tar” cigarettes (used by more older than younger smokers) are “less harmful” (Hamilton et al, 2004; Shiffman, Pillitteri, Burton, Rohay, & Gitchell, 2001), and quitting at older ages is futile or even harmful (Cataldo, 2007; Smith, 2007).…”

Response to Serrano‐Alarcón et al. (2019): Tobacco control policy and smokers aged 65 years and older

“…Indeed, several studies suggest that older smokers tend to be less interested in stopping smoking and less likely to make quit attempts compared to younger smokers . In addition, older smokers tend to have more misperceptions regarding the harms of smoking, including the belief that nicotine is the primary disease‐causing agent in cigarettes .…”