Elders are a population not usually considered for smoking cessation strategies. According to Nursing Standard (2004) there is evidence in the literature that suggests that health care professionals are not targeting elderly patients who smoke. In fact many elderly patients are being ignored when it comes to providing smoking cessation education. Many barriers have been evaluated within the literature that deters nurses from teaching smoking cessation to their elderly patients. Cataldo (2007) discusses the myths and realities of caring for elderly patients who smoke. She highlights several common myths which impede smoking cessation such as the damage of smoking is irreversible, therefore the healthcare professional should not bother with smoking cessation strategies. However smoking cessation practices even in elderly patients over 65 years old have proven significant health benefits as evidenced by the findings. The author continues with an United States study that states, “…men who quit smoking at age 65 years old gained 1.4 to 2.0 years of life and women gained 2.7 to 3.7 years of life” (Cataldo, 2007). These findings are extremely significant because it supports the idea of improving health outcomes for elders that are considering smoking cessation. Elderly patients will see significant benefits such as reduced mortality rates, increase activity tolerance, a decrease in respiratory symptoms such as shortness of breath, wheezing and coughing, overall quality of life improvement. Other challenges with the elderly population are the misconception that elders who smoke longer will have a harder time quitting. Conversely, the literature highlights that elderly populations are more likely to quit smoking than the younger population (Cataldo, 2007). The commitment rates for smoking cessation have also been studied and elderly patient over 65 years old are more likely to quit smoking and less likely too relapse as opposed to a younger group (Cataldo, 2007; US Department of Health and Human Services, 2008).

According to the Surgeon General’s report entitled, Health Consequences of Smoking: What they mean to you (2004), “more than 12 million deaths have been caused by smoking since the first published Surgeon General’s report on smoking in 1964” (Surgeon General's Report, 2004). It is the responsibility of the healthcare providers to promote and provide smoking cessation education and interventions to patients. (Surgeon General's Report, 2004).

In 2004 the Surgeon General reported, “quitting smoking has many benefits. It lowers your risk for diseases and death caused by smoking and improves your health.” The Surgeon General also states that “health goals for reducing smoking will prevent 7.1 million early deaths after 2010 (The Health Consequences of Smoking, 2004).

The Department of Health and Human Services Healthy People 2010 program provides a list of health promotion and disease prevention topics within the United States. “Leading health indicators” (Healthy People 2010, 2005) are used to measure the United States major health concerns. Healthy People 2010 states that these health indicators are chosen “on the basis of their ability to motivate action, the availability of data to measure progress, and their importance as public health issues” (Healthy People 2010, 2005). Healthy People 2010 initiatives indicate tobacco use as a “leading health indicator” (Healthy People 2010, 2005). This statement should stand out for the healthcare worker especially the nurse because they have the opportunity to impact indicators prioritized by Healthy People 2010.

Impact and implications on nursing practice

According to the U.S. Surgeon General’s document, The Health Consequences of Smoking (2004) patients who smoke increase demands on healthcare providers. Smokers have more respiratory complications, difficulty in wound healing and have a higher risk for hip fractures. These patients use more health resources, require more hospitalizations and are in need of more skilled nursing care. The U.S. Surgeon also reports that:

“The economic burden of cigarette use is enormous. From 1995 to 1999, smoking-related costs totaled $157.7 billion each year. This figure includes more than $75 billion in direct medical costs for adults (ambulatory care, hospital care, prescription drugs, nursing homes, and other care), about $82 billion in indirect costs from lost productivity, and $366 million for neonatal care. This equals an estimated $3,000 per smoker per year” (The 2004 Surgeon General's Report: The Health Consequences of Smoking, 2004).

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