Le sevrage tabagique chez les seniors est-il plus difficile que chez les jeunes ?

The ageing of the Tunisian population is causing an increase in the number of older smokers, resulting in the diagnosis of more tobacco-related diseases among the elderly. This was a comparative retrospective study of 200 smokers followed in six smoking cessation consultations between 2008 and 2011; one hundred smokers aged 65 and older were compared with 100 younger smokers (age < 45 years). The aim of this study was to identify the characteristics of smoking cessation in the elderly and to identify factors influencing the success of smoking cessation in this category of people. The elderly were as dependent as the young according to their Fagerstrom scores. Motivation and personal initiative had been the main factor behind the decision to quit, regardless of age. However, among the elderly, the advice of their physicians was more likely to have strengthened this initiative. During the withdrawal process, the use of pharmacological means was less frequent among the elderly than among younger subjects (65% vs. 80%). Doctors more frequently prescribed cognitive therapy for smoking cessation among the elderly than among the younger subjects (12% vs. 2%; P < 0.01). The smoking cessation success rate among elderly patients was significantly lower than among the younger subjects (21% vs. 35%; P < 0.005). Predictors of successful smoking cessation among the elderly were: regular monitoring, comorbidities (especially coronary artery disease and hypertension) and smoking initiation after the age of 20 years. Conversely, irregular follow-up, the presence of other addictions besides smoking and poor socioeconomic conditions were predictive factors for failure to quit. As the benefit of smoking cessation is observed whatever the age of the smoker, we can stress the indication for smoking cessation among older smokers, despite the fact that it appears more difficult to achieve. However, the withdrawal process should take into account the physiological and social particularities of the elderly.