A review of smoking cessation interventions for smokers aged 50 and older.
OBJECTIVE
Cigarette smoking poses substantial health risks at any age, but is particularly dangerous for older smokers, who are already at heightened risk for various health conditions. Studies suggest that older smokers are motivated to quit and succeed, but few of these have been randomized controlled trials. There is a need to systematically evaluate the research on effective interventions in older smokers.


METHODS
We followed PRISMA guidelines in the development of this systematic review, which included randomized controlled trials of cessation interventions with smokers aged 50 or older.


RESULTS
We found 740 unique titles matching specified search criteria; 13 met final eligibility criteria. Nearly all the cessation treatments combined counseling with other strategies. Eight studies provided smoking cessation medications. None of the studies used newer forms of technology such as web- or text-based interventions. Nine of the 13 studies reported a significant intervention effect at one or more time points, with three studies reporting sustained treatment effects at 12 mos or longer. In general, more intensive interventions and those with combined approaches including medications and follow-up counseling achieved the best outcomes.


CONCLUSIONS
The quit rates from these studies and the relative effectiveness of different intervention approaches are consistent with the general smoking cessation literature. However, in most studies, treatment effects were of short duration, and absolute quit rates were low, leaving the vast majority of older smokers at high risk for smoking-related health conditions. This systematic review suggests a need for additional research to design and test future interventions specifically tailored for older smokers.
Alere Wellbeing (formerly Free & Clear), Seattle, WA 98104, USA. susan.zbikowski@alere.com
Susan M
SM
Zbikowski
Brooke
B
Magnusson
Jessica R
JR
Pockey
Hilary A
HA
Tindle
Kathryn E
KE
Weaver
D000368:Aged; D003376:Counseling; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D012907:Smoking / Q000188:drug therapy*; D016540:Smoking Cessation