2024-05-03 17:00:00
In terms of smoking prevalence in France, the situation has improved in recent years, going from 30% of smokers in 2000 to 25.5% in 2020.
However, smoking changes depending on the age group: in 2019, 9% of women aged 65 to 75 and 10.4% of men smoked.
According to Santé Publique France in 2020, 4.1% of people between the ages of 76 and 85 smoked every day.
Cognitive decline, heart failure…
One might think that the percentage of people over 65 who smoke is relatively low compared to other age groups.
In fact, it is important for a population that is very concerned about its harmful effects: 70% of deaths from smoking occur among those over 60 years of age.
At age 70, 81% of non-smoking men and 87% of women are still alive, compared to 55% of men who smoke and 68% of women who smoke. At age 80, this gap is even more significant.
But the consequences of smoking go beyond premature mortality: cognitively, elderly smokers do worse than non-smokers, with a faster decline in cognitive functions and a greater risk of Alzheimer’s heart disease and vascular dementia, in particular in cases of hypertension, diabetes or depression.
Smoking among the elderly is also correlated with heart failure. In addition, smoking is a risk factor for postoperative mortality in cardiac surgery in the elderly (14.8% death compared to 2.1% in non-smokers) linked to greater respiratory complications.
Quit smoking, all the benefits!
Dr. Gilles Albrand (Department of Geriatrics of the Hospices Civils de Lyon) is always convinced that quitting smoking is beneficial for a large number of elderly people because life expectancy can be significant.
For him, despite the usual arguments (“a little pleasure that one cannot deny at this age”, “it is too late to stop”), we must encourage and support the person to wean removal
There are many arguments in favor of isolation. Between 70 and 79 years of age, the risk of cardiovascular death is reduced by 27% if he succeeds in smoking.
Gain on life expectancy
At these ages, the National Committee to Combat Smoking (CNCT) saves years of life expectancy if you stop smoking.
The German meta-analysis in people aged 50 – 74 years showed that quitting smoking even at an advanced age was very beneficial and very rapid, with a reduction in cerebrovascular consequences (myocardial infarction, stroke, cardiovascular diseases).
Most of the excess risk disappears within five years of quitting smoking.
Quitting smoking can also limit early cognitive decline, as well as the risk of heart failure, etc. but also immediate risks, such as those associated with surgical intervention.
Significant risks associated with tobacco
In fact, smoking affects the functioning of the immune system, which is already much less effective at these complex ages, so there is an increased risk of infection in the case of surgery.
In addition, due to smoking, there are increased risks of complications associated with certain surgical procedures after the age of 65, such as complications in placing dental implants, increased post-operative complications especially in orthopedic surgery, healing problems, or even bone reconstruction in the case of a fracture.
Finally, starting to quit smoking after 65 years of age provides a better quality of life, breathing will improve, as will taste and smell.
How to talk about quitting smoking with a senior?
It is on a case by case basis, answers Dr Gilles Albrand. In fact, you have to be very pragmatic, depending on the clinical context.
If carers and those close to them sometimes have to accept that the elderly person continues to smoke, sometimes it is necessary to quit. There are also some types of elderly smokers, for whom quitting must be adapted..
“Older smokers are mostly long-term smokers, making them very dependent, points out the geriatrics. So it may be more difficult for them to quit smoking. But some of these older people, on the other hand, started smoking later in life in response to difficult events, such as the death of a loved one, retirement or isolation. »
Tools such as nicotine replacement therapy and cognitive-behavioral therapy are equally useful with younger smokers. It has also been shown that older smokers are as likely, or even more likely, to successfully quit smoking than younger smokers.
More information: The National Committee to Fight Tobacco
Sources: Follow-up to the session of January 27, 2024: French Pneumology Conference (January 26 to 28, 2024 in Lille), presentation by Dr. Gilles Albrand (Department of Geriatrics of the Hospices Civils de Lyon) entitled Tobacco: a poison for all ages of life; Pasquereau A, Andler R, Arwidson P, Guignard R, Nguyen-Thanh V. Tobacco consumption among adults: an assessment of five years of the national program against tobacco, 2014-2019 Bull Epidemiol Hebd. 2020;(14):273-81; Mons U, Müezsinler A, Gellert C, et al CHANCES Consortium. BMJ. 2015 Apr 20;350:h1551; “Smoking among older people: there is no age to quit smoking” (“for the elderly.gouv”)
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