Its Never Too Late To Stop: Tobacco Cessation for Senior Citizens

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Its Never Too Late To Stop Tobacco Cessation
for Senior Citizens

• Objectives
• Identify stages of change and types of senior
  smokers
• Describe sessions of comprehensive curriculum and
  intervention strategies targeting seniors
• Identify types of screenings for participants
• I

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Its Never Too Late To Stop Tobacco Cessation
for Senior Citizens

• Experiences with the program
• Senior citizens need more group support
• and frequent encouragement to change
• behavior
• Curriculum components could be expanded to a 12
  week behavior modification program
• I

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Its Never Too Late To Stop Tobacco Cessation
for Senior Citizens

• The Challenges...

• Develop a draft cessation curriculum
• Field test the curriculum
• Research to further construct a model cessation
  program

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• Can you Imagine?
• Giving up smoking after 50 years
• Giving up coffee after 50 years
• Giving up chocolate after 50 years
• How would you deal with changing your behavior
  and what kind of programs would be available for
  help?

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Stages of Change (TTM)

• Pre-contemplation
• Contemplation
• Preparation
• Action
• Maintenance

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Seniors and Smoking

• Lowest smoking prevalence of all age
• groups Highest rate of those in
• maintenance stage
• Gain in total number of senior smokers
• Fewer interested in quitting (57.1 vs. 68.2)
• least likely to have tried to quit in past
  year
• More at preparation stage

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Stage of Change Distribution for Current Smokers
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Sub-types Among Senior Smokers

• The Pre-contemplation Rejecters
• The Discouraged Pre-contemplators
• The Active Avoiders
• Early Contemplators

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Rejecters

• Highly addicted
• Heavy to moderate smokers
• Few or no lifetime quits
• No intention to quit

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Discouraged

• Highly addicted
• Heavy smokers
• Multiple lifetime quits
• Conditional intention to quit

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Active Avoiders

• Moderate to low addiction
• Moderate to light smokers
• Long term or vague intent to quit
• Few or no quit attempts OR has multiple prolonged
  stops with restarts

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Early Contemplators

• Classic contemplation stage
• Health event or externally driven
• Shorter-term intent to quit

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Implications for Cessation Programming

• Cessation intervention must start at the pre-
• contemplation stage
• Establish ask, assess, advise, assist in
  community-
• based settings
• Train staff to use client-centered counseling to
  support movement toward cessation
• Use simple typing protocol Build in richer
  reinforcement for movement

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Its Never Too Late To Stop Tobacco Cessation
for Senior Citizens

• Curriculum Development
• and Session Content
• Joy Shepherd

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Program Content

• Targets seniors local advertising
• Pre-and post-health screening and questionnaire
• 1 hour sessions weekly for four weeks
• 6 weeks of nicotine replacement therapy

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Session 1 Thinking About Quitting

• Thinking about quitting
• Reasons seniors want to quit
• Reasons they smoke
• Habit
• Psychological dependence
• Physical addiction
• Set a Quit Date!

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Session 2 Understanding How to Quit

• Health hazards (Acute, Long-term, and
  Environmental)
• Why quit after this long?
• Stages of quitting and ways to stop
• Quit tips
• Let them talk!

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Session 3 Understanding Withdrawal and Avoiding
Weight Gain

• History of failure
• Cravings and stress
• Weight gain and how to avoid it
• Eating habits and exercise
• How to cope with withdrawal symptoms
• Let them talk!

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Session 4 Understanding Relapse

• Handling a relapse and tips to cope with urges
• Common triggers
• Marking progress
• Rewards from quitting
• Let them know they CAN do it
• and stick with it!

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Tips for success

• Advertise locally TV, Radio, Flyers
• Congratulate them on even small improvements!
• Give them a certificate!
• Encourage the development of a support group!
• Let them talk!

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Its Never Too Late To Stop Tobacco Cessation
for Senior Citizens

• Project Activities
• Phyllis Martin

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Smoking Cessation Classes For Senior Citizens

• 5 counties Poinsett, Craighead, Clay,
  
  Lawrence, Cross
• 55 years and older
• Initial and post blood pressure, body
  temperature and lung function screenings
• Free 6 week supply of nicotine replacement
  patches
• 6 month follow up survey and screenings

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• Smoking Cessation Classes
• Class size 1-10
• Ages range from 55 to 70
• Most working part-time or not at all
• Smokers for 30 50 years

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• Health Screening Results
• Initial Lung Function
• Mild restriction/obstruction
• Moderate restriction
• Severe obstruction
• Moderate severe obstruction
• 3 Week Post Lung Function
• Moderate/mild restriction
• Mild obstruction

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Health Screening Results

• 6 Month Post Lung Function
• Severe Restriction/obstruction
• Mild Restriction
• Moderate Severe Restriction

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• Health Screening Results
• Initial Blood Pressure
• 180/89
• 141/85
• 164/102
• 116/54
• 149/92
• 161/100

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Health Screening Results

• 3 Week Post Blood Pressure
• 158/78
• 122/79
• 120/59
• 107/57
• 155/57
• 150/50

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Health Screening Results

• 6 Month Post Blood Pressure
• 130/79
• 115/73
• 115/73
• 97/62
• 161/82

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• Health Screening Results
• Initial Body Temperature
• 98.1
• 97.6
• 97.1
• 97.2
• 99.2
• 97.3

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Health Screening Results

• 3 Week Post Body Temperature
• 97.6
• 98.3
• 97.2
• 98.3
• 97.7
• 98.4

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Health Screening Results

• 6 Month Post Body Temperature
• 97.9
• 98.7
• 97.1
• 97.5
• 98.6

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• Case Study 1
• Age 69 year old Race White female
• Started Smoking Sophomore year in college
• Years Smoked 50 years 1pack per day
• Quit Date March 5, 2003 Method Cold
  Turkey
• As of November 2003, still not smoking!!

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• Case Study 2
• Age 68 years old Race White male
• Started Smoking 11 years old
• Years Smoked 50 years 2 pack per day
• Quit Date February 4, 2003 Method NRP
• As of November 2003, still not smoking

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• Conclusion of Classes
• Strong recruitment is essential
• Participants receptive to material
• Participants shared common experiences
• Group support is important factor to
  participants
• Nicotine replacement very helpful

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• Presentations to Elementary Schools
• Letters sent to 36 schools in the 5 county area
• 6 schools requested speakers
• Target 4th grade students
• Group range 50- 235
• Speakers Volunteer Senior Citizens and
• Program Coordinator
• Pre- and post-surveys given to students

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Presentations to Schools

• Information Presented
• Chemicals in cigarettes
• Cost of smoking
• Health dangers of smoking
• Dangers of second hand smoke

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• Presentations to Schools (Cont.)
• Information Presented
• Other effects of smoking
• Dental
• Smell in clothes,car, house, etc
• Models presented
• Death of a Lung
• Mr. Gross Mouth
• A years Worth of Tar

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• Findings at Schools
• Some students already smoking.
• Students very receptive to comparison of
  money spent on cigarettes vs. money being
  saved for toys, clothes, etc.
• Students very receptive to models shown and
  to senior citizens presentations.
• Students very receptive to health risks
  associated with smoking.

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Conclusions

• Cessation intervention must start at the
• Pre-contemplation stage
• Congratulate participants on small successes
• Group support is important to participants
• Let participants talk
• Health screenings are important to show
• participants health improvements