Smoking cessation and its determinants among older American Indians: the Strong Heart Study

To examine the relationship between sociodemographic, clinical, and smoking history factors, and smoking cessation among older American Indians.

Nested cohort study of cigarette smokers in the Strong Heart Study, a longitudinal study of cardiovascular disease among American Indians.

Thirteen American Indian tribes from Arizona, Oklahoma, and North and South Dakota.

American Indian men and women (N = 998), aged 45-74 years, who identified themselves as smokers at the initial Strong Heart Study examination.

Twenty-one percent of smokers quit during the 4-year follow-up period. Multivariate logistic regression was used to assess the relationship between baseline sociodemographic, clinical, and smoking history factors, and smoking cessation. Factors associated with smoking cessation included being 65-74 years old (odds ratio [OR] 2.1; 95% confidence interval [CI], 1.3 to 3.3), being examined at the Arizona regional center (OR 2.2; 95% CI 1.3, 3.7), being non-daily smokers (OR 5.4; 95% CI 1.3, 18.5), smoking fewer than 6 cigarettes daily (OR 2.8; 95% CI 1.3, 4.7), being a smoker for fewer years(OR 2.0; 95% CI 1.0, 3.9), beginning to smoke at an older age (17 years or older, OR 1.6; 95% CI 1.1, 2.4), and having a history of diabetes (OR 1.7; 95% CI 1.2, 2.3). Factors not associated with smoking cessation included gender, level of education, childhood exposure to tobacco smoking, and a history of cardiovascular diseases, cancer, or respiratory diseases.

Several determinants of smoking cessation among older American Indians identified in this study may have important implications for designing appropriate interventions for this special population.