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Partnership to promote smoking cessation in older adults

Institution: Institute on Aging
Investigator(s): Glenna Dowling, Ph.D., R.N. Sharon Hall, Ph.D.
Award Cycle: 2002 (Cycle 11) Grant #: 11BT-1900 Award: $101,367
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Pilot CARA

Initial Award Abstract
This pilot project is a collaborative partnership between the Institute On Aging (IOA), the University of California, San Francisco (UCSF) Treatment Research Center and Multipurpose Senior Services Programs (MSSP). MSSP is a state wide case management program designed to delay or prevent placement of older adults in nursing facilities by promoting health and by securing home safety. Although approximately 10% of MSSP clients smoke, to date, the promotion of smoking cessation has not been a focus of MSSP and the perceptions of both clients and their healthcare providers are that smoking cessation will provide minimal benefit. In addition, there are no smoking cessation services available that are tailored to meet the needs of homebound ethnically diverse older adults and traditional clinic-based programs are unlikely to reach these clients. Smoking has serious negative effects on health, is one of the most important factors leading to general loss of function, mobility and independence in older individuals and is significantly associated with nursing home placement. Smoking is a risk factor for 7 of the 14 major causes of death in persons 65 years and older. In addition, people 65 and older experience fire fatality rates that are twice as high as those for younger people with smoking and smoking materials being the leading causes of fatal fires.

While little research has been done on interventions to promote smoking cessation in older adults, the limited data available indicate that smoking cessation provides dramatic health benefits and that older smokers will participate in smoking cessation interventions. The goals of this Pilot CARA are to: 1) strengthen the collaboration between the IOA Research Center, IOA MSSP and UCSF Treatment Research Center, and form new partnerships with additional MSSP sites; 2) compare demographic, psychological, cognitive and physical functioning profiles in smoking and non- smoking MSSP clients; 3) assess a subset of MSSP clients’ perceptions of and experience with smoking cessation programs; 4) assess MSSP case managers’ perceptions of and experience with smoking cessation programs; and 5) establish a Smoking Cessation Task Force with membership from the IOA, UCSF Treatment Research Center and MSSP clients and staff to formulate culturally sensitive, MSSP specific, smoking cessation intervention strategies and generate hypotheses to be tested in a Full CARA.

The results from this Pilot CARA will enable us to develop intervention strategies and hypotheses to be tested in a Full CARA and will create the infrastructure, critical to the design of effective smoking cessation interventions for older adults that are accepted by the community. The project will also increase the knowledge base about specific design requirements of smoking cessation interventions for community dwelling ethnically diverse homebound older adults and identify the potential factors that might prevent health care providers from promoting smoking cessation interventions in this population. The results from the Full CARA should help to decrease tobacco use in community dwelling older adults and consequently decrease the many of the negative effects associated with smoking in older adults including functional decline, fire hazard and nursing home admission.

Smoking in older clients of case management programs and case managers' perception of smoking cessation.
Periodical: The Gerontologist Index Medicus:
Authors: Schmitt E, Dowling G, Tsoh J, Hall S ABS
Yr: 2003 Vol: 43 Nbr: SI 1 Abs: Pg: 224-225