Department of Behavioural Science and Health, University College London, 1-19, London, Torrington Place, WC1E 7HB, UK.
SPECTRUM Consortium, Edinburgh, UK.
BMC Med. 2024 Oct 31;22(1):500. doi: 10.1186/s12916-024-03728-x.
This study aimed to characterise patterns of tobacco smoking and vaping among older adults (≥ 65 years) in England, to explore harm perceptions of e-cigarettes among those who smoke, and to estimate the real-world effectiveness of e-cigarettes for helping older adults to stop smoking.
Data were collected as part of a representative monthly cross-sectional household survey in England between April 2014 and April 2024 (n = 197,219). We analysed differences between older (≥ 65 years) and younger/middle-aged adults (18-64 years) in (a) time trends in tobacco smoking and vaping, (b) harm perceptions of e-cigarettes vs. cigarettes (adjusting for gender, socioeconomic position, and vaping status), and (c) the real-world effectiveness of e-cigarettes for smoking cessation (adjusting for gender, socioeconomic position, characteristics of the quit attempt, and use of other evidence-based cessation aids).
Tobacco smoking prevalence remained relatively unchanged over time among older adults (at ~ 9%; 9.5% [8.5-10.6%] in April 2014 and 8.7% [7.7-9.8%] in April 2024) but vaping prevalence increased (from 2.1% [1.6-2.7%] to 3.7% [3.0-4.6%], respectively). These trends differed from those observed among younger/middle-aged adults, among whom there was a clear decline in smoking (from 21.8% [21.0-22.7%] to 18.2% [17.3-19.0%]) and a larger increase in vaping (from 5.6% [5.2-6.1%] to 16.2% [15.3-17.0%]). Older adults were consistently less likely than younger/middle-aged adults to use e-cigarettes to support attempts to quit smoking (26.8% [17.2-39.3%] vs. 43.7% [39.6-48.0%] in April 2024). Older smokers reported greater uncertainty about the harms of e-cigarettes compared with cigarettes (OR = 2.48 [2.28-2.69]). E-cigarettes appeared to be effective for helping older adults to stop smoking (OR = 1.50 [0.96-2.34]); whether effectiveness was lower than for younger/middle-aged adults was inconclusive.
Over the past decade, smoking prevalence has remained stable among older adults while decreasing among the rest of the adult population in England. Older adults are more unsure about the relative harms of e-cigarettes and less likely to use them to support attempts to quit smoking, despite evidence that they are effective for smoking cessation in this population.
本研究旨在描述英国≥65 岁老年人中吸烟和蒸气烟的模式，探讨吸烟者对电子烟危害的认知，并估计电子烟在帮助老年人戒烟方面的实际效果。
数据来自 2014 年 4 月至 2024 年 4 月期间在英国进行的一项具有代表性的每月横断面家庭调查（n=197219）。我们分析了老年人（≥65 岁）和年轻/中年成年人（18-64 岁）之间（a）吸烟和蒸气烟时间趋势的差异，（b）电子烟与香烟危害认知的差异（调整性别、社会经济地位和蒸气烟状态），以及（c）电子烟在戒烟方面的实际效果（调整性别、社会经济地位、戒烟尝试的特征和其他基于证据的戒烟辅助工具的使用）。
在老年人中，吸烟率在过去十年中相对保持不变（约为 9%；2014 年 4 月为 8.5-10.6%，2024 年 4 月为 8.7%-9.8%），但蒸气烟率有所上升（分别从 2.1%（1.6-2.7%）升至 3.7%（3.0-4.6%））。这些趋势与年轻/中年成年人的观察结果不同，后者吸烟率明显下降（从 21.8%（21.0-22.7%）降至 18.2%（17.3-19.0%）），蒸气烟率上升幅度更大（从 5.6%（5.2-6.1%）升至 16.2%（15.3-17.0%））。老年人在支持戒烟尝试方面使用电子烟的可能性始终低于年轻/中年成年人（2024 年 4 月分别为 26.8%（17.2-39.3%）和 43.7%（39.6-48.0%））。老年吸烟者对电子烟危害的不确定性比对香烟危害的不确定性更大（OR=2.48[2.28-2.69]）。电子烟似乎对帮助老年人戒烟有效（OR=1.50[0.96-2.34]）；电子烟的效果是否低于年轻/中年成年人，尚无定论。
在过去十年中，英国≥65 岁老年人的吸烟率保持稳定，而其他成年人口的吸烟率下降。尽管有证据表明电子烟在这一人群中对戒烟有效，但老年吸烟者对电子烟相对危害的不确定性更大，且更不可能使用电子烟来支持戒烟尝试。
