Older smokers' motivation and attempts to quit smoking: epidemiological insight into the question of lifestyle versus addiction.
BACKGROUND
Much media attention currently focuses on demands from the organized medical profession in Germany for an altered legal framework regarding remuneration for smoking-cessation interventions. With this development, the question whether smoking is an autonomously chosen lifestyle or, alternatively, an addiction constituting a disease in its own right has once again come to the fore of public debate.


METHODS
In a population-based study in the German state of Saarland, 10,000 persons aged 50 to 74 were questioned about their health-related behavior and medical history. The frequency of attempts to quit smoking, and of the motivation to do so, was analyzed in relation to the total number of smokers in the survey and was stratified with respect to existing illnesses whose cardiovascular risk potential is exacerbated by smoking.


RESULTS
Among 1528 persons who were smokers at the beginning of the study, 76% (95% confidence interval [CI]: 73.7%-78.0%) reported having tried to quit at least once. Among smokers with existing high-risk conditions, this figure was higher, reaching 89% (CI: 83.1%-93.0%) in smokers with known cardiovascular disease. Only 11% of the smokers were content with their smoking behavior; 30% said they wanted to cut down, and 59% said they wanted to quit smoking entirely.


CONCLUSIONS
Most older smokers in Germany would like to quit smoking and have tried to do so repeatedly without success. In particular, high-risk patients with comorbidities, whose number will further increase as the population ages, are highly motivated to quit smoking and would derive major benefit from effective assistance with smoking cessation. The description of smoking as an autonomously chosen lifestyle appears cynical and deserves to be vigorously rejected.
Breitling
Lutz Ph
LP
Rothenbacher
Dietrich
D
Stegmaier
Christa
C
Raum
Elke
E
Brenner
Hermann
H
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016739:Behavior, Addictive / Q000453:epidemiology* / Q000517:prevention & control*; D015897:Comorbidity; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009042:Motivation; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention