Smoking and Older Adults

Older smokers are at greater risks from smoking because they have smoked longer (an average of 40 years), tend to be heavier smokers, and are more likely to suffer from smoking-related illnesses. They are also significantly less likely than younger smokers to believe that smoking harms their health.1

Key Facts About Tobacco Use Among Older Adults

  • Today's generation of older Americans had smoking rates among the highest of any U.S. generation. In the mid-1960s, about 54 percent of adult males were current smokers and another 21 percent were former smokers; in 2008, about 23 percent of adult males were smokers and another 24 percent were former smokers.2
  • In 2008, over 17 million Americans over the age of 45 smoked, accounting for over 22 percent of all adult smokers. Nine percent of Americans over 65 years of age currently smoked.3

Health Effects of Smoking

  • An estimated 438,000 Americans die each year from diseases caused by smoking. Smoking is responsible for more than one in five U.S. deaths.4 About half of all regular cigarette smokers will eventually be killed by the addiction.5
  • Smoking is directly responsi­ble for more than 90 percent of chronic obstructive pulmonary disease (COPD, or em­physema and chronic bronchi­tis) deaths and approximately 80 to 90 percent of lung cancer deaths in women and men, respectively. Smoking is also a major risk factor for coro­nary heart disease, stroke and lower respiratory tract infections - all leading causes of death in those over 50 years of age.6
  • COPD prevalence rates are highest among those 65 years of age and older and the disease consistently ranks among the top ten most common chronic health conditions and sources of daily activity limitation. COPD is the fourth-leading cause of death and is predicted to become third by 2020.7
  • Men 65 or older who smoke are twice as likely to die from a stroke, and women smokers are about one and a half times as likely to die from a stroke than their nonsmoking counterparts. The risk of dying from a heart attack is 60 percent higher for smokers than nonsmokers 65 or older.8
  • Cigarette smokers have a far greater chance of developing dementia of any kind including Alzheimer's disease compared to nonsmokers.9 Smokers also have two to three times the risk of developing cataracts, the leading cause of blindness and visual loss, as nonsmokers.10
  • Smoking reduces one's normal life expectancy by an average of 13 to 15 years - thereby eliminating retirement years for most smokers.11

Benefits of Quitting Smoking for Older Adults

  • Quitting smoking has proven health benefits, even at a late age. When an older person quits smoking, circulation improves immediately, and the lungs begin to repair damage. In one year, the added risk of heart disease is cut almost in half, and risk of stroke, lung disease, and cancer diminish. Among smokers who quit at age 65, men gained 1.4 to 2.0 years of life and women gained 2.7 to 3.4 years.12
  • Just cutting down on cigarettes, but not quitting entirely, does not reduce mortality risks from tobacco-related diseases.13
  • A study found that middle-aged smokers and former smokers with mild or moderate chronic obstructive pulmonary disease breathed easier after quitting. After one year the women who quit smoking had 2 times more improvement in lung function compared with the men who quit.14
  • Many older adults say they do not quit smoking because doing so offers no benefit at an advanced age. However, there is strong evidence that smoking cessation even late in life not only adds years to life, but also improves quality of life. Similar to this belief, most obstacles brought up by older adults for not quitting are based on incorrect information, such as the potential health risks from cessation aids like nicotine replacement therapy.15
  • Although most former smokers preferred quitting cold turkey, less than 5 percent will have long term success.16 Using a tobacco treatment plan doubles the quitting success rate. Treatments for quitting smoking have been found to be effective and could decrease health care costs. Effective treatments combine counseling and medications.17

For more information on tobacco, please review the Trends in Tobacco Use report in the Data and Statistics section of our website at, or call the American Lung Association at 1-800-LUNG-USA (1-800-586-4872).

February 2010


1 Rimer BK, Orleans CT, Keintz MK, Cristinzio S, & Fleisher L. The older smoker: status, challenges and opportunities for intervention. Chest. 1990; 97:547-53.
2 Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey, 1965-2006. Calculations for 1997-2006 were performed by the American Lung Association Research and Program Services Division using SPSS and SUDAAN software.
3 Ibid.
4 Centers for Disease Control and Prevention. Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 1997–2001.
Morbidity and Mortality Weekly Report. July 1, 2005; 54(25):625-628. Accessed on October 3, 2007.
5 World Health Organization. Programmes and Projects. Tobacco Free Initiative.
WHO Report on Global Tobacco Epidemic, 2008 – The MPOWER Package: Tobacco Facts. Accessed March 3, 2008.
6 Centers for Disease Control and Prevention. Department of Health and Human Services. Health Consequences of Smoking: A Report of the Surgeon General, 2004.
7 Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2010.
Progress Review: Respiratory Health. June 29, 2004. Accessed on February 29, 2008.
8 Centers for Disease Control and Prevention. Annual Smoking-Attribute Mortality, Years of Potential Life Lost, and Economic Costs – United States, 1995-1999. Morbidity and Mortality Weekly Report. 2002;51(4):3003-3.
9 Anstey KJ, von Sanden C, Salim A, O'Kearney R. Smoking as a Risk Factor for Dementia and Cognitive Decline: A Meta-Analysis of Prospective Studies. American Journal of Epidemiology. August 15 2007; 166:367-378.
10 U.S Department of Health and Human Services. Health Consequences of Smoking: A Report of the Surgeon General, 2004.
11 Ibid.
12 Taylor DH, Hasselblad V, Henley J, Thun MD, & Sloan FA. Benefits of Smoking Cessation for Longevity. American Journal of Public Health. 2002; 92:990-6.
13 Godtfredsen NS, Holst C, Prescott E, Vestbo J, & Olser M. Smoking Reduction, Smoking Cessation, and Mortality: A 16-year Follow-up of 19,732 Men and Women from the Copenhagen Centre for Prospective Population Studies. American Journal of Epidemiology. 2002; 156:994-1001.
14 Connett JE, Murray RP, Buist AS, Wise RA, Bailey WC, Lindgren PG, Owens GR. Changes in Smoking Status Affect Women More than Men: Results of the Lung Health Study. American Journal of Epidemiology. 2003; 157: 973-979.
15 Kerr S, Watson H, Tolson D, Lough M, & Brown M. Developing Evidence-Based Smoking Cessation Training/Education Initiatives in Partnership with Older People and Health Professionals. Caledonian Nursing & Midwifery Research Centre: Glasgow 2004.
16 Hughes JR, Keely J & Naud S. Shape of the Relapse Curve and Long-Term Abstinence Among Untreated Smokers. Addiction. January 2004; 99:29-38.
17 U.S. Department of Health and Human Services. Public Health Service. Clinical Practice Guideline. Treating Tobacco Use and Dependence: 2008 Update. May 2008.