HEALTH & SCIENCE

Never too old to quit: You can help the elderly stop smoking

Older smokers face a unique set of challenges when it comes to kicking the cigarette habit, and primary care physicians are central to their success.

By Stephanie Stapleton, AMNews staff. Feb. 21, 2005.

You know the patient. He's 68. His pallor is gray. He exhibits a chronic cough and complains about diminishing stamina. It's obvious he needs to stop smoking. But when was the last time you asked him about his habit or counseled him to quit?

It's a question that deserves your attention -- at least as much as the other vital signs you chart.

According to the American Medical Association, physicians should screen adults for tobacco use and provide cessation counseling at every patient encounter. The advice should be personal, medically oriented, clear and strong. Studies show that even very brief counseling sessions, less than three minutes, result in modest but statistically significant improvements in tobacco-cessation rates, notes the American College of Preventive Medicine.

However, even these interventions are often easier said than done. And when the smoker in front of you is older, that challenge can seem even more daunting.

That's why a recent draft Medicare coverage decision is viewed as a step forward. In December 2004, the Bush administration announced that the Centers for Medicare & Medicaid Services intends to provide new coverage allowing certain Medicare beneficiaries who smoke to receive tobacco cessation counseling services.

The policy is based on evidence indicating that, regardless of a smoker's age, kicking the habit will lead to immediate and long-term benefits, including lowered blood pressure, improved lung function and reduced risk for heart attack. Ultimately, the coverage could save as many as 95,000 years of life over a 10-year period, experts predict.

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