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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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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. / Jordan, Hannah; Hidajat, Mira; Payne, Nick; Adams, Jean; White, Martin; Ben-Shlomo, Yoav.

In: BMJ Open, Vol. 7, No. 11, 15.11.2017, p. e018150.

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@article{e041b687b36d48d681ae815e73d84581,
title = "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",
abstract = "OBJECTIVES: To investigate whether age is associated with access to smoking cessation services.DESIGN: Data from the Smoking Toolkit Study 2006-2015, a repeated multiwave 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 general practitioner (GP) raised the topic of smoking and made referrals for pharmacological support (prescription of nicotine replacement therapies (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+ were more likely not to be referred for NRT or other support (ORs relative to 16-54 years; 70-74 years 1.27, 95{\%} CI 1.03 to 1.55; 75-79 years 1.87, 95{\%} CI 1.43 to 2.44; 80+ years 3.16, 95{\%} CI 2.20 to 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 GPs. 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.",
keywords = "Journal Article",
author = "Hannah Jordan and Mira Hidajat and Nick Payne and Jean Adams and Martin White and Yoav Ben-Shlomo",
note = "{\circledC} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2017",
month = "11",
day = "15",
doi = "10.1136/bmjopen-2017-018150",
language = "English",
volume = "7",
pages = "e018150",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "11",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - What are older smokers' attitudes to quitting and how are they managed in primary care?

T2 - An analysis of the cross-sectional English Smoking Toolkit Study

AU - Jordan, Hannah

AU - Hidajat, Mira

AU - Payne, Nick

AU - Adams, Jean

AU - White, Martin

AU - Ben-Shlomo, Yoav

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017/11/15

Y1 - 2017/11/15

N2 - OBJECTIVES: To investigate whether age is associated with access to smoking cessation services.DESIGN: Data from the Smoking Toolkit Study 2006-2015, a repeated multiwave 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 general practitioner (GP) raised the topic of smoking and made referrals for pharmacological support (prescription of nicotine replacement therapies (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+ were more likely not to be referred for NRT or other support (ORs relative to 16-54 years; 70-74 years 1.27, 95% CI 1.03 to 1.55; 75-79 years 1.87, 95% CI 1.43 to 2.44; 80+ years 3.16, 95% CI 2.20 to 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 GPs. 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.

AB - OBJECTIVES: To investigate whether age is associated with access to smoking cessation services.DESIGN: Data from the Smoking Toolkit Study 2006-2015, a repeated multiwave 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 general practitioner (GP) raised the topic of smoking and made referrals for pharmacological support (prescription of nicotine replacement therapies (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+ were more likely not to be referred for NRT or other support (ORs relative to 16-54 years; 70-74 years 1.27, 95% CI 1.03 to 1.55; 75-79 years 1.87, 95% CI 1.43 to 2.44; 80+ years 3.16, 95% CI 2.20 to 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 GPs. 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.

KW - Journal Article

U2 - 10.1136/bmjopen-2017-018150

DO - 10.1136/bmjopen-2017-018150

M3 - Article

C2 - 29146649

VL - 7

SP - e018150

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 11

ER -