The relationship between smoking history and current functioning in disabled community-living older adults.
OBJECTIVE
This study was conducted to determine characteristics associated with continued cigarette use in frail older adults and to examine how smoking history relates to current psychiatric, cognitive, and occupational functioning.


METHODS
Archival records were gathered for 1,064 patients (69% women) who entered On Lok SeniorHealth Services between January 1996 and December 2000. Participants were interviewed on program entry and assessed for smoking history, depressive symptoms, affective disorders, cognitive functioning, alcohol use, and physical functioning (activities of daily living [ADLs] and instrumental ADLs). Cross-sectional analyses were conducted to examine functioning at enrollment relative to smoking history.


RESULTS
Smoking history was related to age at program entry, with current smokers entering On Lok at an earlier age than former or never smokers. Current smokers were more likely to be male, to be of Caucasian or African American descent, to consume alcohol on a regular basis, and to be more independent on ADLs. Specifically, they were more independent on tasks related to their capacity to procure cigarettes or continue smoking, including shopping, using transportation, managing money, dressing themselves, and walking. Smoking history was related to depression, with symptoms lower for current and former smokers.


CONCLUSIONS
Current smokers present for services at an earlier age and have higher levels of independence on ADLs instrumental to nicotine use. Data indicate characteristics associated with continued smoking and provide a foundation for targeting older individuals for cessation efforts.
Haas
Amie L
AL
San Francisco Treatment Research Center and Department of Psychiatry, University of California at San Francisco, CA, USA. ahaas1@scu.edu
Eng
Catherine
C
Dowling
Glenna
G
Schmitt
Eva
E
Hall
Sharon M
SM
D000203:Activities of Daily Living; D001741:Black or African American / Q000523:psychology; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000523:psychology; D003071:Cognition; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology*