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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Low rates of cigarette smoking among elderly in Maryland. Is it a cohort effect or differential quitting rates?

Fatma Shebl, MD, MSc, MHS1, Eileen K. Steinberger, MD, MS2, Diane Dwyer, MD3, Carmela Groves, RN, MS3, Annette Hopkins, RN, MS2, Min Zhan, PhD2, and Ebenezer Israel, MD, MPH4. (1) Epidemiology, University Of Maryland at Baltimore, 660 West Redwood street, Howard hall, suit 100, Baltimore, MD 21201, (2) Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Suite 100 Howard Hall, 660 West Redwood Street, Baltimiore, MD 21209, (3) Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, 201 West Preston Street, Baltimore, MD 21201, (4) Unversity of Maryland and ESPRI, Baltimore, 21201

Objective: To assess whether observed lower smoking rates in elderly is explained as cohort effect or differential quitting rates.

Methods: Maryland Cancer Survey 2004, was a population-based, random digit-dial, computerized assisted telephone interview of 5,004 persons 40 years and older. Current smoking rate was compared between those 40-64 years and 65+ years. Logistic regression was used to adjust for possible confounders.

Results: Current smoking rates were 20% in the 40-64 year old cohort versus 8% of those 65+. The differences of the current smoking rates between the two age groups persisted after adjusting for possible confounding variables such as education, income, race, marital status, and sex (OR= 2.8, 95%CI= 2.1,3.9). The rate of “ever smoked” was not different between the two groups (50% vs. 52%). Among “ever smokers” the 40-64 year olds were less likely to have quit smoking (61%) than those 65+ (84.2%) (OR= 0.3, 95%CI= 0.2,0.4). We found an interaction between gender and age. Men 40-64 years were significantly less likely than older men to have “ever smoked” (OR= 0.6, 95%CI= 0.5,0.8) but also less likely to have quit; women aged 40-65 were slightly more likely to have “ever smoked” than women 65+ (OR= 1.1, 95%CI= 0.9,1.3).

Conclusion: The lower current smoking rates observed in elderly men seem to be primarily due to increased quitting in older age groups and not due to a cohort effect. However, in women, the lower rate in those 65+ could be explained by both increased quitting rate and a possible cohort effect.