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Most smokers have a physical dependency on nicotine, which is found in tobacco. Smoking cessation programs use one or a variety of techniques including aversion therapy, hypnosis, acupuncture, acupressure, and individual and/or group therapy or mutual support groups to help people who wish to control their dependence on nicotine and give up smoking.  The southeasthealthline website provides links to services.

Alcohol and drug programs provide therapy and mutual support for individuals who abuse drugs and/or alcohol, to help them better understand their dependency and to support their efforts to recover. The southeasthealthline website provides links to services.

Older adults suffer a large proportion of health consequences from smoking and could benefit from cessation.

Why is it important?

  • Smoking is a risk factor for lung cancer, heart disease, stroke, chronic respiratory disease and fractures (6)
  • Smoking is the leading cause of premature death (5)
  • Rate of bone-density decline in older adults is accelerated by smoking (4)
  • Female smokers are at greater risk of post-menopausal osteoporosis (4)
  • Smoking cessation later in life adds years to life and also improves quality of life (1) (2)

Common Causes

  • Stress of unemployment,  homelessness, personal problems, financial strain, or physical/verbal abuse (8)
  • Addiction to alcohol, cocaine, or heroin can make one vulnerable to smoking (8)
  • Older smokers are less likely to believe smoking harms health or cessation offers benefits at advanced age (1)

Key Considerations

  • Talk to your physician about current smoking status: amount smoked, previous experience with quitting, other influential factors (e.g. addictions/medications/psychiatric problems), current interest in quitting, and any concerns (3)
  • Discuss appropriateness of smoking cessation products/medication with physician (e.g.  nicotine patch, nicotine gum, nicotine inhaler, nicotine lozenge, nicotine mouth spray, varenicline, bupropion, etc) (7)
  • Take advantage of alternative treatments such as counseling, group therapy, community smoking cessation programs- ask your family health team for information
  • Discuss strategies with health care staff to help manage stress, avoid weight gain, deal with setbacks (7)
  • Get involved in the plan to quit smoking and identify areas in which you will need help: choose a quit date, decide on a quit method, know your triggers, conquer cravings, manage withdrawal, build social supports, and control/maintain a “smoke-free” environment (7)
  • Friends and family can help by asking what they can do, being understanding and available, avoiding nagging, and celebrating success (7)
  • Those ready to quit can get support- QuitNow provides online forums and resources for caregivers/family members (7) (http://www.quitnow.ca/)

References



1. 
Brenner, H ,Gellert, C., Holleczek, B., Müller, H. & Schöttker, B.  (2013). Impact of smoking and quitting on
     cardiovascular outcomes and risk advancement periods among older adults
. European Journal of Epidemiology,
     28(8), 649-658.  Retrieved Feb. 2014 from:
     http://www.citeulike.org/user/denraymachin/article/12629715

2.  Health Canada. (2002). Healthy Aging: Tobacco Use and Smoking Cessation Among Seniors

     Retrieved February 26, 2014 from:
     http://publications.gc.ca/collections/Collection/H39-612-2002-5E.pdf

3.  Statistics Canada. (2012). Current Smoking Trends. Retrieved February 26, 2014 from:  
     http://www.statcan.gc.ca/pub/82-624-x/2012001/article/11676-eng.pdf

4. 
Statistics Canada. (2012). Smoking. Retrieved February 26, 2014 from:
     http://www.statcan.gc.ca/pub/82-625-x/2013001/article/11844-eng.htm

5. 
The Lung Association. (2014).  Quit Now. Retrieved February 27, 2014 from:
     http://www.quitnow.ca

6.  World Education. (2009). From the First to the Last Ash: The History, Economics & Hazards
     of Tobacco
. Retrieved February 26, 2014 from:
     http://healthliteracy.worlded.org/docs/tobacco/Unit3/1why_people_smoke.html

Older adults suffer a large proportion of health consequences from smoking and could benefit from cessation.

Why is it important?

  • Smoking is a risk factor for lung cancer, heart disease, stroke and chronic respiratory disease (7)
  • Smoking is the leading cause of premature death; heavy smokers can lose about 9 years of life expectancy (6)
  • Older smokers are at greater risks because they have smoked longer: 61% of senior non-smokers are actually former smokers;  and they tend to be heavier smokers as 86% smoked daily (7) (1)
  • Cessation later in life adds years to life and improves quality of life: e.g. risk of myocardial infarction and stroke is reduced by 40% or more  within 5 years after the last cigarette (1) (2)
  • Intensive smoking cessation treatment has been shown to significantly reduce re-hospitalization (9)

Common Causes

  • Stress of unemployment,  homelessness, personal problems, financial strain, or physical/verbal abuse (10)
  • Addiction to alcohol, cocaine, or heroin can make one vulnerable to smoking (10)
  • Older smokers are less likely than younger smokers to believe smoking harms health or cessation offers benefits at advanced age (1)

As people age, they naturally become more sensitive to the effects of alcohol. Older adults are not able to absorb alcohol at the rate they once did which causes the alcohol to stay in their bodies longer. An older adult drinking the same amount as a younger adult will have a higher percentage of alcohol in their body.(4) The combination of these effects lowers the body’s tolerance for alcohol.

Why is it important?

  • An older adult can develop alcohol-related problems even when drinking habits remained the same (4)
  • Heavy drinking can damage the liver, heart, brain, muscle and bone
  • Heavy drinking can increase risk of cancers and immune disorders (4)
  • Drinking can make existing health conditions worse: diabetes, memory problems, high blood pressure, congestive heart failure, mood disorders and osteoporosis (4)

Common Causes

  • Major life changes (e.g. death of a loved one, moving to a new home, failing health, poverty) can cause loneliness,boredom, anxiety, or depression (3)
  • Older adults faced with large amounts of free time after retirement may turn to alcohol (5)

Key Considerations

  • Read labels on all medications and follow the directions as some medication labels warn not to drink alcohol when taking medicine; ask your health care provider or pharmacist whether it's okay to drink alcohol while taking a specific medicine (4)
  • Discuss concerns with health care provider; ask for referral to support group or counseling service
  • Set limits for yourself, eat before and while drinking, always consider your age, weight and health problems
  • Older adults should never exceed Canada’s Low-Risk Alcohol Drinking Guidelines: 2 drinks per day or 10 drinks per week for women; 3 drinks per day or 15 drinks per week for men (2)
  • Although drinking may provide health benefits for certain people, it is not recommended to start drinking to increase health benefits (1)

References

1.      Canadian Centre on Substance Abuse. (2013). Canada’s Low-Risk Alcohol Drinking Guidelines. 
         Retrieved March 5, 2014 from:
         http://www.ccsa.ca/Resource%20Library/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf

2.      Canadian Centre on Substance Abuse. (2012). Canada’s Low-Risk Alcohol Drinking Guidelines: 
         Frequently Asked Questions. Retrieved March 5, 2014 from:
         http://www.sbir-diba.ca/docs/default-document-library/2012-faqs-canada-low-risk-alcohol-drinking-guidelines

3.      National Institute on Aging.  (2014). Alcohol Use in Older People. Retrieved March 5, 2014 from: 
         http://www.nia.nih.gov/health/publication/alcohol-use-older-people

4.      NIH. (2012). Alcohol Use and Older Adults. Retrieved March 5, 2014 from: 
         http://nihseniorhealth.gov/alcoholuse/alcoholandaging/01.html

5.      PHAC. (2010). The Chief Public Health Officer’s Report on The State of Public Health in Canada 2010.
         Retrieved March 5, 2014 from:
         http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2010/fr-rc/cphorsphc-respcacsp-06-eng.php

Additional Resources

1.      Seeking Solutions Project.  (2004) BEST PRACTICES:  alcohol and other substance use withdrawal
         Retrieved March 2014 from:
         http://www.agingincanada.ca/BEST_7.PDF

2.      Seeking Solutions Project.  (2004) BEST PRACTICES:  using harm reduction.  Retrieved March 2014 from: 
         http://www.agingincanada.ca/Best_3.pdf

Smoking Cessation Best Practice Champion Workshop

The Registered Nurses’ Association of Ontario (RNAO) invites all nurses, nursing students and other health care professionals to attend a FREE one day workshop on Smoking Cessation Best Practice

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