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Tobacco is implicated in more disability and death for older adults than any other substance and is the most common substance use disorder among older individuals. In the United States, there are 4.5 million smokers older than age 65. More than 30% of men and 25% of women older than 65 smoke. One in three smokers die prematurely in the United States, losing an average of 12 to 15 years of life from their projected normal life expectancy, thereby eliminating the retirement years (Center for Social Gerontology, 1999). Smoking tobacco is associated with all the major causes of death among older adults, years of disability and suffering, and increased health care costs, yet the focus on smoking cessation in older adults has been minimal.
In the past decade, the negative health effects of smoking among middle-aged adults has been well documented. Associations of smoking among older adults with quality-of-life outcomes such as morbidity, disability, and well-being has received limited attention. There have been few studies to investigate the effects of smoking and the benefits of smoking cessation for older adults. As a result, much of the information provided to older smokers is based on misinformation and myth.
The purpose of this article is to discuss the epidemiology of tobacco use, the health effects of tobacco use and psychiatric co-morbidities associated with smoking and older adults. The second part of this article, which will be published in a future issue of the Journal of Gerontological Nursing, focuses on myths and realities involved in the care of the older smoker, how to break these barriers, and how to most effectively treat the older smoker.
EPIDEMIOLOGY OF TOBACCO USE IN OLDER ADULTS
Worldwide, 3 million deaths a year are estimated to be attributable to smoking, and this number will rise to 10 million a year by 2020 Peto et al., 1996). Nationally approximately 13% of individuals ages 65 and older are smokers and approximately 26% of individuals ages 50 to 64 are smokers. Currently in the United States (those individuals born between 1900 and 1948 who are now older than 50) have smoking rates among the highest of any U.S. generation (Center for Social Gerontology, 1999).
The current epidemic of smokingrelated deaths is the result of these high...