Smoking cessation behavior in older adults by race and gender: the role of health problems and psychological distress

Nicotine Tob Res. 2009 Apr;11(4):433-43. doi: 10.1093/ntr/ntp002. Epub 2009 Mar 18.


Introduction: Initial research on older smokers suggests that a subgroup of smokers with higher levels of psychological distress and health problems may be more likely to quit smoking than older smokers with fewer such problems. The present study, based on prospective data from a biracial sample of older adults (N = 4,162), examined characteristics of older adult smokers by race and gender.

Methods: The present study uses both cross-sectional and prospective data to examine the association between smoking behavior, smoking cessation, health functioning, and psychological distress in a biracial sample of community-dwelling older adults.

Results: We found baseline psychological distress to be associated with poor health functioning. Consistent with hypotheses, baseline (Time 1) psychological distress predicted smoking cessation 3 years later (Time 2). Moreover, the change in health problems between Time 1 and Time 2 fully mediated the association between Time 1 distress and smoking cessation.

Discussion: Smoking cessation behavior of older adults is best explained by higher levels of distress and health problems regardless of race or gender. These findings may have important treatment implications regarding smoking cessation programs among older adults. Older adult smokers with higher levels of psychological distress and health problems may be more motivated to quit smoking than those with fewer such problems. These difficulties should be targeted within the context of the smoking cessation protocol. Also, we identified a subgroup of older smokers who are reporting fairly good health and lower levels of distress and who are less likely to quit smoking. Motivational methods may need to be developed to engage this group in smoking cessation treatment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Racial Groups*
  • Sex Factors*
  • Smoking Cessation / psychology*
  • Stress, Psychological*