Nicotine - Older Adults (50+): Difference between revisions

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=Misperceptions=

='''Misperceptions'''=

===2023: [https://tobaccocontrol.bmj.com/content/33/e2/e266.long Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke]===

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***Acknowledgement: This study was funded by the Health Research Council of New Zealand (grant 06/453).

=Smoking and Smoking Cessation=

='''Smoking and Smoking Cessation'''=

*See Also: Smokeless Products

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*For some older adults, such as those living below the federal poverty line, smoking prevalence has increased from 13% to 16% between 2011 and 2022. At the same time, older adults are the fastest-growing demographic worldwide, and for the first time in history, their numbers are predicted to exceed those of young people.

**Citation: Kleykamp BA, Smith H, Dewan M, Kalinowski LM, Parsky J, Kulak JA. Lost in the Smoke: Underrepresentation of Aging Adults in Nicotine and Tobacco Research. Nicotine Tob Res. 2025 Jan 30:ntaf029. doi: 10.1093/ntr/ntaf029. Epub ahead of print. PMID: 39883072.

===2025: [https://www.ingentaconnect.com/contentone/png/ajhb/2025/00000049/00000001/art00009 E-cigarettes and Older Adults who Smoke: A Missed Opportunity to Further Reduce Harm?]===

*Manufacturers should consider the barriers to e-cigarette use by older adults who are smoking and design products that are appealing to older smokers. Reducing smoking prevalence in this group is a public health priority.

===2025: [https://www.edwardanselmmd.com/help-for-seniors Help for Seniors]===

*"Several recent government publications including the 2024 Surgeon General’s Report should make us ask if the Department of Health and Human Services and the Centers for Disease Control understand the impact of smoking on health and health care costs for seniors?"

**Source: Website of Edward Anselm, MD, Public Health Advocate

===2024: [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03728-x Use, perceptions, and effectiveness of e-cigarettes for smoking cessation among older adults in England: a population study, 2014–2024]===

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**Citation: Meza R, Cao P, Jeon J, Warner KE, Levy DT. Trends in US Adult Smoking Prevalence, 2011 to 2022. JAMA Health Forum. 2023 Dec 1;4(12):e234213. doi: 10.1001/jamahealthforum.2023.4213. PMID: 38038988; PMCID: PMC10692849.

***Acknowledgement: This research was supported by grant U54CA229974 from the NCI and FDA Center for Tobacco Products (all authors) and grant U01CA253858 from the NCI (Drs Meza, Cao, Jeon, and Levy).

===2023: [https://pmc.ncbi.nlm.nih.gov/articles/PMC10257741/ The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit]===

*Logistic regressions assessed interactions of age (<60 vs. ≥ 60 years) by predictors in relation to quit attempts and six-month cessation controlling for treatment.

*Conclusion: Well-known predictors of quit success were differentially associated with quitting in older age (≥60 years) after receiving standard cessation care in primary care. Although older adults in this sample were less nicotine dependent than those younger overall, older adults with high nicotine dependence were less likely to make a quit attempt or successfully quit compared to their younger counterparts. Nicotine dependence could be an important consideration in cessation treatment with older populations; such that older adults with higher dependence might need more intensive treatment including proactive approaches to ensure ease of access to nicotine replacement therapy or other cessation pharmacotherapy. Following standard cessation advice, older adults attempted to quit and succeeded at a similar rate as those younger. Further, older adults unmotivated to quit were more likely to quit compared to unmotivated younger adults.

**Citation: Fahey MC, Dahne J, Wahlquist AE, Carpenter MJ. The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit. J Appl Gerontol. 2023 Jul;42(7):1477-1485. doi: 10.1177/07334648231158228. Epub 2023 Feb 16. PMID: 36797652; PMCID: PMC10257741.

***Acknowledgement: Funding for this research was provided by National Institute on Drug Abuse (R01 DA021619), (K23 DA045766), (T32 DA007288). Clinical Trials registration number NCT02096029.

===2021: [https://tobaccocontrol.bmj.com/content/early/2021/08/12/tobaccocontrol-2021-056945 Ignoring our elders: tobacco control’s forgotten health equity issue]===

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**Citation: Le Grande M, Borland R, Yong HH, McNeill A, Fong G, Cummings KM. Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020). Nicotine Tob Res. 2022 Mar 26;24(5):679-689. doi: 10.1093/ntr/ntab230. PMID: 34755869; PMCID: PMC9122748.

***Acknowledgement: The ITC Four Country Smoking and Vaping Project in Australia, Canada, US, and England was supported by the National Health and Medical Research Council of Australia (APP1106451), US National Cancer Institute (P01CA200512), and Canadian Institutes of Health Research (FDN-148477). GTF was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. GTF has served as an expert witness on behalf of governments in litigation involving the tobacco industry. KMC has been a consultant and received grant funding from the Pfizer Inc. in the past 5 years. K.M.C has also been a paid expert witness in litigation against the tobacco industry. All other authors have no conflicts of interest to declare.

===2021: [https://pmc.ncbi.nlm.nih.gov/articles/PMC7885790/ Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking]===

*Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps < .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up.

**Citation: Pearson JL, Zhou Y, Smiley SL, Rubin LF, Harvey E, Koch B, Niaura R, Abrams DB. Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking. Nicotine Tob Res. 2021 Feb 16;23(3):527-534. doi: 10.1093/ntr/ntaa086. Erratum in: Nicotine Tob Res. 2024 Dec 23;27(1):163. doi: 10.1093/ntr/ntae234. PMID: 32421191; PMCID: PMC7885790.

***Acknowledgement: The research reported in this publication was supported by the National Institute on Drug Abuse (grant number 1R21DA036472) of the National Institutes of Health under grant number 5R21DA036472. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7885790/#s0106 Disclosures]

===2020: [https://www.sciencedirect.com/science/article/pii/S0085253815469595 Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population]===

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**Source: Annie Kleykamp, ''Filter Magazine''

===2018: ~~Power Point~~: [https://~~archive~~.~~gfn~~.~~events~~/~~downloads/2018/AnnieKleykamp.pdf~~ Rethinking nicotine across the lifespan: What about the older smoker?]===

===2018: Video: [https://www.youtube.com/watch?v=NGzw5ndFnIw Rethinking nicotine across the lifespan: What about the older smoker?]===

*GFN: Annie Kleykamp, PhD

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**Citation: Kleykamp, B. A., & Heishman, S. J. (2011). The Older Smoker. JAMA, 306(8). doi:10.1001/jama.2011.1221

=Smokeless Products=

='''Smokeless Products'''=

*See also: Smoking and Smoking Cessation

===ENDS (NVP, E-Cigarettes, E-Cigs, Vapes)===

==='''ENDS (NVP, E-Cigarettes, E-Cigs, Vapes)'''===

====2023: [https://www.phcc.org.nz/briefing/vaping-prevalence-and-trends-key-findings-2022-23-nz-health-survey Vaping prevalence and trends: key findings in the 2022-23 NZ Health Survey]====

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***Acknowledgement: This research was supported in part by funding from the National Institutes of Health (R01CA19044 [CDD and MBS] and K01DA037950 [JLP]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.

===Snus===

==='''Snus'''===

====2021: [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-01979-6 Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals]====

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***Acknowledgements: Work of the authors is supported by grants from the Geriatric Foundation, research for healthy aging, and Börjeson, Emil and Ragna Foundation (to O.E.T.), the Swedish Research Council for Health, Working Life and Welfare (Forte; grant number 2018-00123) (to S.C.L.), the Swedish Research Council (Vetenskapsrådet; grant number 2016-01042 and 2019-00977) (to S.C.L.), and the Swedish Heart-Lung Foundation (Hjärt-Lungfonden; grant number 20190247) (to S.C.L.). The study was also supported by additional grants from the Swedish Research Council (https://www.vr.se; grant no 2015-03257, 2017-00644 and 2017-06100 to KM). SIMPLER receives funding through the Swedish Research Council under the grant no 2017-00644 (to Uppsala University and KM). SNIC is financially supported by the Swedish Research Council. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Open Access funding provided by Uppsala University.

=Therapeutic Benefits=

='''Therapeutic Benefits'''=

===Auditory===

==='''Auditory'''===

====2021 [https://www.nature.com/articles/s41598-021-92588-z Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers]====

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**Citation: Sun, S., Kapolowicz, M.R., Richardson, M. et al. Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers. Sci Rep 11, 13187 (2021). doi: 10.1038/s41598-021-92588-z

===Memory and Cognitive Ability===

==='''Memory and Cognitive Ability'''===

====[https://mindstudy.org/ MIND (Memory Improvement through Nicotine Dosing) Study]====

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**Citation: Levin ED, Rezvani AH. Nicotinic treatment for cognitive dysfunction. Curr Drug Targets CNS Neurol Disord. 2002 Aug;1(4):423-31. doi: 10.2174/1568007023339102. PMID: 12769614.

===Mental Health===

==='''Mental and Behavorial Health'''===

====2020 [https://www.sciencedirect.com/science/article/abs/pii/S0028390819305003?via%3Dihub Regulation of aggressive behaviors by nicotinic acetylcholine receptors: Animal models, human genetics, and clinical studies]====

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***Acknowledgement: Supported by NIH grants K24 MH110598 and CTSA award UL1TR000445 from the National Center for Advancing Translational Sciences.

=Very Low Nicotine Content Cigarettes=

='''Very Low Nicotine Content Cigarettes'''=

===2021: [https://pmc.ncbi.nlm.nih.gov/articles/PMC8372658/ Responses to Gradual and Immediate Reduction of Nicotine in Cigarettes in Young Versus Older Adult Smokers]===

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***Acknowledgements: The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration. Research supported by a grant from the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products (U54DA031659; Donny/Hatsukami). Manuscript preparation supported by NCI K01CA189300 (PI Cassidy), K01DA047433 (Smith), and NIDA P50DA036114.

=See Also=

='''See Also'''=

===[https://www.youtube.com/@goldenoldiescapitoltours6536 Golden Oldies Capitol Tours]===

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===[https://safernicotine.wiki/mediawiki/index.php/Old_farts_vaping Old Farts Vaping]===

=Suggestions to add to this page=

='''Suggestions to add to this page'''=

@@ Line 3: / Line 3: @@
-=Misperceptions=
+='''Misperceptions'''=
 ===2023: [https://tobaccocontrol.bmj.com/content/33/e2/e266.long Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke]===
@@ Line 16: / Line 16: @@
 ***Acknowledgement: This study was funded by the Health Research Council of New Zealand (grant 06/453).
-=Smoking and Smoking Cessation=
+='''Smoking and Smoking Cessation'''=
 *See Also: Smokeless Products
@@ Line 27: / Line 27: @@
 *For some older adults, such as those living below the federal poverty line, smoking prevalence has increased from 13% to 16% between 2011 and 2022. At the same time, older adults are the fastest-growing demographic worldwide, and for the first time in history, their numbers are predicted to exceed those of young people.
 **Citation: Kleykamp BA, Smith H, Dewan M, Kalinowski LM, Parsky J, Kulak JA. Lost in the Smoke: Underrepresentation of Aging Adults in Nicotine and Tobacco Research. Nicotine Tob Res. 2025 Jan 30:ntaf029. doi: 10.1093/ntr/ntaf029. Epub ahead of print. PMID: 39883072.
+===2025: [https://www.ingentaconnect.com/contentone/png/ajhb/2025/00000049/00000001/art00009 E-cigarettes and Older Adults who Smoke: A Missed Opportunity to Further Reduce Harm?]===
+*Manufacturers should consider the barriers to e-cigarette use by older adults who are smoking and design products that are appealing to older smokers. Reducing smoking prevalence in this group is a public health priority.
+===2025: [https://www.edwardanselmmd.com/help-for-seniors Help for Seniors]===
+*"Several recent government publications including the 2024 Surgeon General’s Report should make us ask if the Department of Health and Human Services and the Centers for Disease Control understand the impact of smoking on health and health care costs for seniors?"
+**Source: Website of Edward Anselm, MD, Public Health Advocate
 ===2024: [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03728-x Use, perceptions, and effectiveness of e-cigarettes for smoking cessation among older adults in England: a population study, 2014–2024]===
@@ Line 51: / Line 58: @@
 **Citation: Meza R, Cao P, Jeon J, Warner KE, Levy DT. Trends in US Adult Smoking Prevalence, 2011 to 2022. JAMA Health Forum. 2023 Dec 1;4(12):e234213. doi: 10.1001/jamahealthforum.2023.4213. PMID: 38038988; PMCID: PMC10692849.
 ***Acknowledgement: This research was supported by grant U54CA229974 from the NCI and FDA Center for Tobacco Products (all authors) and grant U01CA253858 from the NCI (Drs Meza, Cao, Jeon, and Levy).
+===2023: [https://pmc.ncbi.nlm.nih.gov/articles/PMC10257741/ The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit]===
+*Logistic regressions assessed interactions of age (<60 vs. ≥ 60 years) by predictors in relation to quit attempts and six-month cessation controlling for treatment.
+*Conclusion: Well-known predictors of quit success were differentially associated with quitting in older age (≥60 years) after receiving standard cessation care in primary care. Although older adults in this sample were less nicotine dependent than those younger overall, older adults with high nicotine dependence were less likely to make a quit attempt or successfully quit compared to their younger counterparts. Nicotine dependence could be an important consideration in cessation treatment with older populations; such that older adults with higher dependence might need more intensive treatment including proactive approaches to ensure ease of access to nicotine replacement therapy or other cessation pharmacotherapy. Following standard cessation advice, older adults attempted to quit and succeeded at a similar rate as those younger. Further, older adults unmotivated to quit were more likely to quit compared to unmotivated younger adults.
+**Citation: Fahey MC, Dahne J, Wahlquist AE, Carpenter MJ. The Impact of Older Age on Smoking Cessation Outcomes After Standard Advice to Quit. J Appl Gerontol. 2023 Jul;42(7):1477-1485. doi: 10.1177/07334648231158228. Epub 2023 Feb 16. PMID: 36797652; PMCID: PMC10257741.
+***Acknowledgement: Funding for this research was provided by National Institute on Drug Abuse (R01 DA021619), (K23 DA045766), (T32 DA007288). Clinical Trials registration number NCT02096029.
 ===2021: [https://tobaccocontrol.bmj.com/content/early/2021/08/12/tobaccocontrol-2021-056945 Ignoring our elders: tobacco control’s forgotten health equity issue]===
@@ Line 60: / Line 73: @@
 **Citation: Le Grande M, Borland R, Yong HH, McNeill A, Fong G, Cummings KM. Age-Related Interactions on Key Theoretical Determinants of Smoking Cessation: Findings from the ITC Four Country Smoking and Vaping Surveys (2016-2020). Nicotine Tob Res. 2022 Mar 26;24(5):679-689. doi: 10.1093/ntr/ntab230. PMID: 34755869; PMCID: PMC9122748.
 ***Acknowledgement: The ITC Four Country Smoking and Vaping Project in Australia, Canada, US, and England was supported by the National Health and Medical Research Council of Australia (APP1106451), US National Cancer Institute (P01CA200512), and Canadian Institutes of Health Research (FDN-148477). GTF was supported by a Senior Investigator Grant from the Ontario Institute for Cancer Research. GTF has served as an expert witness on behalf of governments in litigation involving the tobacco industry. KMC has been a consultant and received grant funding from the Pfizer Inc. in the past 5 years. K.M.C has also been a paid expert witness in litigation against the tobacco industry. All other authors have no conflicts of interest to declare.
+===2021: [https://pmc.ncbi.nlm.nih.gov/articles/PMC7885790/ Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking]===
+*Smokers older than 45 and those who started smoking at a younger age rated e-cigarettes as less satisfying (ps < .05). Participants with greater than the median reported satisfaction were 6.5 times more likely to use an e-cigarette at follow-up.
+**Citation: Pearson JL, Zhou Y, Smiley SL, Rubin LF, Harvey E, Koch B, Niaura R, Abrams DB. Intensive Longitudinal Study of the Relationship Between Cigalike E-cigarette Use and Cigarette Smoking Among Adult Cigarette Smokers Without Immediate Plans to Quit Smoking. Nicotine Tob Res. 2021 Feb 16;23(3):527-534. doi: 10.1093/ntr/ntaa086. Erratum in: Nicotine Tob Res. 2024 Dec 23;27(1):163. doi: 10.1093/ntr/ntae234. PMID: 32421191; PMCID: PMC7885790.
+***Acknowledgement: The research reported in this publication was supported by the National Institute on Drug Abuse (grant number 1R21DA036472) of the National Institutes of Health under grant number 5R21DA036472. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7885790/#s0106 Disclosures]
 ===2020: [https://www.sciencedirect.com/science/article/pii/S0085253815469595 Tobacco, hypertension, and vascular disease: Risk factors for renal functional decline in an older population]===
@@ Line 70: / Line 88: @@
 **Source: Annie Kleykamp, ''Filter Magazine''
-===2018: Power Point: [https://archive.gfn.events/downloads/2018/AnnieKleykamp.pdf Rethinking nicotine across the lifespan:  What about the older smoker?]===
+===2018: Video: [https://www.youtube.com/watch?v=NGzw5ndFnIw Rethinking nicotine across the lifespan:  What about the older smoker?]===
 *GFN: Annie Kleykamp, PhD
@@ Line 87: / Line 105: @@
 **Citation: Kleykamp, B. A., & Heishman, S. J. (2011). The Older Smoker. JAMA, 306(8). doi:10.1001/jama.2011.1221
-=Smokeless Products=
+='''Smokeless Products'''=
 *See also: Smoking and Smoking Cessation
-===ENDS (NVP, E-Cigarettes, E-Cigs, Vapes)===
+==='''ENDS (NVP, E-Cigarettes, E-Cigs, Vapes)'''===
 ====2023: [https://www.phcc.org.nz/briefing/vaping-prevalence-and-trends-key-findings-2022-23-nz-health-survey Vaping prevalence and trends: key findings in the 2022-23 NZ Health Survey]====
@@ Line 105: / Line 123: @@
 ***Acknowledgement: This research was supported in part by funding from the National Institutes of Health (R01CA19044 [CDD and MBS] and K01DA037950 [JLP]). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.
-===Snus===
+==='''Snus'''===
 ====2021: [https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-01979-6 Swedish snuff (snus) and risk of cardiovascular disease and mortality: prospective cohort study of middle-aged and older individuals]====
@@ Line 112: / Line 130: @@
 ***Acknowledgements: Work of the authors is supported by grants from the Geriatric Foundation, research for healthy aging, and Börjeson, Emil and Ragna Foundation (to O.E.T.), the Swedish Research Council for Health, Working Life and Welfare (Forte; grant number 2018-00123) (to S.C.L.), the Swedish Research Council (Vetenskapsrådet; grant number 2016-01042 and 2019-00977) (to S.C.L.), and the Swedish Heart-Lung Foundation (Hjärt-Lungfonden; grant number 20190247) (to S.C.L.). The study was also supported by additional grants from the Swedish Research Council (https://www.vr.se; grant no 2015-03257, 2017-00644 and 2017-06100 to KM). SIMPLER receives funding through the Swedish Research Council under the grant no 2017-00644 (to Uppsala University and KM). SNIC is financially supported by the Swedish Research Council. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Open Access funding provided by Uppsala University.
-=Therapeutic Benefits=
+='''Therapeutic Benefits'''=
-===Auditory===
+==='''Auditory'''===
 ====2021 [https://www.nature.com/articles/s41598-021-92588-z Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers]====
@@ Line 121: / Line 139: @@
 **Citation: Sun, S., Kapolowicz, M.R., Richardson, M. et al. Task-dependent effects of nicotine treatment on auditory performance in young-adult and elderly human nonsmokers. Sci Rep 11, 13187 (2021). doi: 10.1038/s41598-021-92588-z
-===Memory and Cognitive Ability===
+==='''Memory and Cognitive Ability'''===
 ====[https://mindstudy.org/ MIND (Memory Improvement through Nicotine Dosing) Study]====
@@ Line 158: / Line 176: @@
 **Citation: Levin ED, Rezvani AH. Nicotinic treatment for cognitive dysfunction. Curr Drug Targets CNS Neurol Disord. 2002 Aug;1(4):423-31. doi: 10.2174/1568007023339102. PMID: 12769614.
-===Mental Health===
+==='''Mental and Behavorial Health'''===
 ====2020 [https://www.sciencedirect.com/science/article/abs/pii/S0028390819305003?via%3Dihub Regulation of aggressive behaviors by nicotinic acetylcholine receptors: Animal models, human genetics, and clinical studies]====
@@ Line 178: / Line 196: @@
 ***Acknowledgement: Supported by NIH grants K24 MH110598 and CTSA award UL1TR000445 from the National Center for Advancing Translational Sciences.
-=Very Low Nicotine Content Cigarettes=
+='''Very Low Nicotine Content Cigarettes'''=
 ===2021: [https://pmc.ncbi.nlm.nih.gov/articles/PMC8372658/ Responses to Gradual and Immediate Reduction of Nicotine in Cigarettes in Young Versus Older Adult Smokers]===
@@ Line 186: / Line 204: @@
 ***Acknowledgements: The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration. Research supported by a grant from the National Institute on Drug Abuse and the Food and Drug Administration Center for Tobacco Products (U54DA031659; Donny/Hatsukami). Manuscript preparation supported by NCI K01CA189300 (PI Cassidy), K01DA047433 (Smith), and NIDA P50DA036114.
-=See Also=
+='''See Also'''=
 ===[https://www.youtube.com/@goldenoldiescapitoltours6536 Golden Oldies Capitol Tours]===
@@ Line 192: / Line 210: @@
 ===[https://safernicotine.wiki/mediawiki/index.php/Old_farts_vaping Old Farts Vaping]===
-=Suggestions to add to this page=
+='''Suggestions to add to this page'''=