Management of tobacco dependence in older adults: using evidence-based strategies.

Reducing tobacco use is a leading goal of the nation's Healthy People 2010. To improve the health of all Americans during the first decade of the 21st century, tobacco control practices must be a top priority. Tobacco use is a chronic disease with multiple relapses, especially in older adults. Older adult smokers are often less educated, have a low socioeconomic status, are more likely to be female, and have reduced self-efficacy with the cessation process. Older adults suffer disproportionately from smoking-related diseases, yet experience physical, social, and psychological rewards from cessation. Older adults want to quit smoking and do so at similar rates of younger adults. Treating tobacco dependence in older adults should have the same consideration as treatment of other chronic diseases such as diabetes, hypertension, and hyperlipidemia. Clinicians managing the care of smokers can be effective in promoting smoking cessation, regardless of the smoker's age or duration of smoking history. The AHRQ guideline recommends clinicians ask, advise, assess, assist, and arrange follow-up for all smokers. Pharmacological and behavioral therapies are recommended to assist with the cessation process. Gerontological nurses can play a key role in optimizing health and successsful aging by reducing tobacco use in older adults.