A review of cessation interventions for older adult smokers

Audience: Clinicians, Researchers, Policy Makers.

Key Points: 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.  We conducted a systematic literature review of randomized controlled trials of cessation interventions with smokers aged 50 or older following PRISMA guidelines.  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 months or longer. In general, more intensive interventions and those with combined approaches including medications and follow-up counseling achieved the best outcomes.  The quit rates from these studies and the relative effectiveness of different intervention approaches are consistent with the general smoking cessation literature. However, the 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. 

Educational Experience: We present a synopsis of the published literature and the gaps in the existing literature and opportunities for improving treatment for older smokers.

Benefits: The results of our systematic literature review will help inform the design of future research with and interventions for older smokers.