Smoking is a known risk factor for many diseases, including multiple cancers, heart disease, stroke, and chronic obstructive pulmonary disease. Sadly, tobacco use is the single most preventable cause of disease, disability and death in the United States. Smoking has disproportionately affected older adults; the current generation of older adults over 75 had the highest rate of smoking of any generation before or since (in 1964, about half of all U.S. adults were cigarette smokers). As a consequence, this population on average has a higher risk of smoking-related diseases.
Quitting smoking is challenging due to the highly addictive nature of nicotine. The vast majority of all smokers over age 65 report having tried to quit smoking, but successful smoking cessation decreases with age; individuals that have been smoking for longer have a harder time quitting.
Additional health benefits of quitting smoking:
You can help educate your parent about the variety of resources and approaches that can help smokers quit. There are hundreds of programs and intervention strategies, and the road to quitting will look different for every smoker. Here are some of the most common strategies that help smokers come up with (and stick to) a smoking cessation plan:
One of the most effective ways to help your parent kickstart a smoking cessation plan is to identify why they want to make a change. As a caregiver, ask your loved one why they are interested in investing time and resources into quitting. For some, it might be health-related; others may feel more motivated by limiting others’ exposure to secondhand smoke. Naming these reasons out loud can help smokers push through the withdrawal phase of the quit plan, especially when they come across a trigger or feel tempted to give up.
Discuss the plan for smoking cessation with your parent before they actually stop smoking. This step may actually take several days or weeks and should be carefully considered. It’s common for smokers to be overly optimistic about their ability to quit, so their initial plan may not be realistic. You may also want to consult with a primary care physician at this stage to ask about a reasonable quitting timeline. The goal is to come up with a sustainable plan that your parent will be able to commit to long-term.
One of the main reasons smokers give up so easily on their plan to quit is because they come across triggering events or circumstances that prompt a desire to smoke. These are different for everyone, but some common triggers include: being around other smokers, stress, boredom, or routines that are centered around smoking. Help your parent develop new routines that promote healthier behavior, such as scheduled walks or time in the garden.
While it is possible to quit smoking alone, it is very challenging to follow through and commit to quitting long-term without using some external resources. Your parent’s primary care physician may help refer you to local support groups, but you can also reach out to the National Cancer Institute telephone quitline or your state's quitline. Simply discussing progress once per week with someone via phone may help your parent stay motivated. There can be stigma against using professional resources that may make your parent feel resistant to counseling; if this is the case, try to normalize the need for support and offer reassurance.
There are some medications that can help curb cravings, such as nicotine replacement therapy (this is available as skin patches, lozenges, gum, inhalers and nasal sprays, and preferences vary widely between smokers). Nicotine replacement therapy should begin on the day your parent quits. Other medication can help prevent withdrawal symptoms by mimicking how nicotine functions in your body. These include bupropion and varenicline and should begin one to two weeks before the quit day.
Discussing smoking with your elderly parent, especially if they have been a lifelong smoker, can feel daunting. Try to resist the urge to tell your parent what to do; this may only make them more hesitant to start the process. They need to feel ready to make the leap.
Rather than judging your parent when they attempt to quit and relapse, try to celebrate the “small wins.” If they were able to make it 2 or 3 days without a cigarette, take the time to acknowledge this progress. These acknowledgements may seem insignificant at the time, but they may be a factor that contributes to their long-term success eventually.
As a non-smoker, it’s hard to understand how challenging it can be to overcome an addiction to nicotine. If your parent attempts to quit and then relapses, try to be patient with them and continue to offer your support when they express feeling ready to quit again.
