What are older smokers' attitudes to quitting and how are they managed in primary care? An analysis of the cross-sectional English Smoking Toolkit Study.
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Jordan, H., Hidajat, M., Payne, N., Adams, J., White, M., & Ben-Shlomo, Y. (2017). What are older smokers' attitudes to quitting and how are they managed in primary care? An analysis of the cross-sectional English Smoking Toolkit Study.. BMJ open, 7 (11), e018150. https://doi.org/10.1136/bmjopen-2017-018150
Objectives To investigate whether age is associated with access to smoking cessation services. Design Data from the Smoking Toolkit Study 2006-15, a repeated multi-wave cross-sectional household survey (N=181,157). Setting England Participants Past-year smokers who participated in any of the 102 waves stratified into age groups. Outcome measures Amount smoked and nicotine dependency, self-reported quit attempts and use of smoking cessation interventions. Self-report of whether the GP raised the topic of smoking and made referrals for pharmacological support (prescription of NRTs) or other support (counselling or support groups). Results Older smokers (75 + years) were less likely to report that they were attempting to quit smoking or seek help from a GP, despite being less nicotine dependent. GPs raised smoking as a topic equally across all age groups, but smokers aged 70 plus were more likely not to be referred for NRT or other support (odds ratios relative to 16-54 years; 70-74 years 1.27, 95%CI 1.03, 1.55; 75-79 1.87, 95% CI 1.43, 2.44; 80+ 3.16, 95% CI 2.20, 4.55; p-value for trend <0.001). Conclusions Our findings suggest that there are potential missed opportunities in facilitating smoking cessation in older smokers. In this large population based study older smokers appeared less interested in quitting and were less likely to be offered support, despite being less addicted to nicotine than younger smokers. It is unclear whether this constitutes inequitable access to services or reflects informed choices by older smokers and their general practitioners. Future research is needed to understand why older smokers and GPs do not pursue smoking cessation. Service provision should consider how best to reduce these variations and a stronger effectiveness evidence base is required to support commissioning for this older population so that, where appropriate, older smokers are not missing out on smoking cessation therapies and the health benefits of cessation at older ages.
Humans, Tobacco Use Disorder, Nicotinic Agonists, Logistic Models, Cross-Sectional Studies, Attitude to Health, Smoking, Smoking Cessation, Counseling, Age Distribution, Sex Distribution, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Primary Health Care, England, Female, Male, Young Adult, Self Report, Smoking Prevention, Tobacco Use Cessation Devices
Wellcome Trust (087636/Z/08/Z)
External DOI: https://doi.org/10.1136/bmjopen-2017-018150
This record's URL: https://www.repository.cam.ac.uk/handle/1810/276963
Attribution 4.0 International
Licence URL: http://creativecommons.org/licenses/by/4.0/
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