Smoking Cessation Treatment Efficacy and Impact on Health Outcomes Among Middle-Aged and Older Adults: A Scoping Review

Middle-aged and older adults (aged ≥ 45 years) have historically been overlooked in tobacco research and policy despite a quit rate that is half of younger adults and the greatest near-term harms of tobacco use. A scoping review was conducted on smoking cessation treatment efficacy and its impact on health outcomes among middle-aged and older adults who smoke. This review was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA) extension for scoping reviews.

Five databases were searched for relevant studies: PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library. Inclusion criteria were: Randomized controlled trials (RCTs) or systematic reviews published since 2008 in English; middle-aged (45-64 years) or older adult (≥ 65 years) populations who were smoking combustible cigarettes or e-cigarettes at enrollment in a tobacco cessation treatment trial; and ≥3-month follow-up period. Outcomes included health effects of smoking cessation or smoking abstinence rates.

A total of 44 articles met eligibility criteria (42 RCTs and two reviews). Six focused on health outcomes, 36 focused on cessation outcomes, and four studies examined both health outcomes and cessation success. Six-month cessation rates ranged from 13% to 52%. Most studies did not stratify by age, but those that did suggested older adults achieved cessation rates equal to or exceeding younger adults with combined intervention of counseling and cessation medications.

Many of the studies did not explicitly focus on older adults, but instead focused on medical conditions more prevalent within aging populations. Future research on older adults should clarify age definitions and report stratified analyses by age.

A scoping review of RCT studies on the effectiveness and health outcomes of smoking cessation interventions in middle-aged (45-64 years) and older adults (≥ 65 years) yielded a total of 44 relevant articles. Results showed that middle-aged and older adult smokers are just as, if not more successful at quitting smoking than their younger counterparts using a combined intervention of counseling and cessation medications. Many of the studies did not explicitly focus on older adults, but instead focused on medical conditions more prevalent within aging populations. Future research on older adults should clarify age definitions and report stratified analyses by age.