The Prevalence and Associated Factors of Smoking and Smoking-Cessation in Iranian Older Adults: Ardakan Cohort Study on Aging (ACSA).

OBJECTIVES

This study aimed to assess the prevalence of smoking, exposure to secondhand smoke, former smoking, and associated factors among older adults.

METHODS

Using data from the cross-sectional phase of the Ardakan Cohort Study on Aging (ACSA), self-reported information on smoking habits, secondhand smoke exposure, and childhood exposure to smoke was analyzed. Logistic regression was employed to evaluate factors influencing being a former smoker, while multinomial logistic regression compared nonsmokers, former smokers, and current smokers.

RESULTS

A total of 4,981 individuals participated in the study, revealing that 22.23% of male participants were former smokers, 28.29% were current smokers, while only 0.19% of females were former smokers, and 0.08% were current smokers. The majority of smokers started smoking before the age of 18, with an average pack year of 26.27 and a smoking duration of 30.37 years (95% CI: 29.83 to 31.59). Exposure to secondhand smoke in homes was reported by 30.41% of women and 10.87% of men, while childhood exposure to cigarette smoke was reported by 30.37% of women and 43.29% of men. Smoking status was found to be associated with age, education, BMI, hypertension, hyperlipidemia, neurological disorders, depressive symptoms, and pack year history.

CONCLUSION

The study highlights a high prevalence of both first- and secondhand smoking in the elderly population of Iran, emphasizing the need for targeted interventions. These findings may inform age- and context-appropriate public health strategies targeting older adults, particularly in regions where smoking remains socially embedded and cessation support is limited.