Determinants of smoking and cessation

Background: although the benefits of quitting smoking even at an advanced age have been proved, few campaigns target the older population. The goals of this study were to analyse the characteristics of older women smokers to help and support those wanting to quit. Methods: we assessed the determinants of smoking cessation in a prospective cohort study performed in 7,609 older women. A questionnaire about smoking habits was sent to the 486 eligible smokers. Smoking dependence and smokers’ readiness to quit was assessed. Participants who had quit smoking during follow-up were asked about their previous reasons for quitting and the methods used to quit. Results: 372 women of the 424 (88%) responded to our questionnaire and were included. The most common reasons for smoking were relaxation, pleasure, and habit. Major obstacles to quitting smoking were ‘no benefit to quitting at an advanced age’, ‘smoking few or ‘‘light’’ cigarettes yields no negative health consequences’, and ‘smoking does not increase osteoporotic risk’. During the 3-year follow-up period, 57 of the 372 (15%) women successfully quit smoking. Being an occasional smoker (OR = 2.4) and reporting ‘quitting is not difficult’ (OR = 3.7) were positively associated with having recently quit smoking. Only 11% of successful cessations were reported to have received physician advice. Conclusions: these data illustrate the specific smoking behaviour of older women, suggesting that cessation interventions ought to be tailored to these characteristics. Willingness to quit was associated with a low education level. The most frequent obstacles to quitting were all based on incorrect information.