Influence of anti- and pro- tobacco messages on older adult risk and benefit perceptions of tobacco use

The absolute negative health burden from smoking is greatest for adults over age 55. Older adults are the least likely to quit of any age group, perhaps because they underestimate both the risks for smoking and the benefits of cessation. While quitting smoking by age 50 halves the risk of lung cancer, and almost immediately decreases cardiovascular risk, older adults are often unaware of these benefits. Currently, there is an increase in tobacco industry advertising to encourage cigarette smokers to use smokeless tobacco and e-cigarettes in no-smoking areas and as an aid to decrease smoking. While these messages are likely to appeal strongly to older smokers, most research on tobacco marketing, risk perception and smoking behavior has been done with adolescents and young adults. Using six focus groups (N=46), the specific aim of this study was to: Characterize older smokers' perceptions of the risks and benefits associated with conventional and emerging tobacco products and determine the extent to which these perceptions relate to exposure to pro- and anti-tobacco messages. Participants were shown pictures and definitions of all tobacco products. Participants exposed to tobacco marketing had increased perceptions of benefits and decreased perceptions of risks of tobacco products, 90% expressed willingness to try new products before trying cessation. Current anti-tobacco images only include older adult images as end of life patients some with tracheotomies. The majority of participants felt that anti tobacco public health messages were “not meant for me”, “are about young people”, and “its too late for us”.