Image by @nichtraucherinitiative
By Fiona McCally
When talking about tobacco use, much of the conversation focuses on health risks associated with tobacco products within specific moments of time. However, the consequences and impacts of tobacco use often develop over years or even decades. While the physical consequences of tobacco use may accumulate over decades, individuals’ understanding of these risks also change as they age, encounter new health policies, or experience changes in their own health.
Cigarette smoking increases the risk of serious health conditions such as lung cancer and cardiovascular disease, while other nicotine-containing products, such as e-cigarettes, can contribute to nicotine dependence and exposure to potentially harmful substances. Understanding tobacco use and perceptions requires more than knowing what products people use or what risks they currently associate with them. Instead, it requires an understanding of how these perceptions develop over long periods of time.
Older adults in particular are an essential population to consider because their experiences, health concerns, and exposure to different tobacco products and policies may shape how they tobacco risk. Unlike younger populations, older adults have exposure to ever-changing tobacco regulations and experiences with tobacco use. Their perceptions are shaped by evolving public messaging and advertisements, introductions of alternative products, as well as governmental regulation changes around tobacco.
Older adults are underrepresented in some areas of tobacco control research. This could explain why tobacco use remains unchanged for older adults for nearly two decades in the United States. Given this, our research team consisting of public health researchers who study scientific evidence, health policy, and regulation regarding tobacco and nicotine products is conducting a scoping analysis of existing literature on public opinion and tobacco policy among adults aged 55 and older in the United States.
We are partway through this screening and we are noticing a gap in longitudinal studies examining tobacco risk perceptions among older adults. Because the health consequences of tobacco use can emerge or even worsen over time, understanding how older adults perceive these risks is especially important.
Much of the research we have come across captures public opinion only at a specific moment in time. While this research can still provide valuable information into how people view tobacco products, longitudinal research is essential to understand how perceptions evolve and change over time. Studying older adult populations in particular requires studies that can account for years and decades of personal experiences in accordance with changing cultural expectations and norms.
For example, an older adult’s perception of smoking risks may change following a health diagnosis, increased awareness of long-term health consequences, or exposure to tobacco control policies. Future studies should potentially track older adults’ perceptions and behaviors across multiple time points instead of at a single point of time, like those in cross-sectional studies.
Providing a more comprehensive picture of factors that influence tobacco-related opinions is essential to understanding tobacco-related attitudes and therefore developing effective public health policies and interventions. Longitudinal studies can account for changes in health status, social circumstances, and exposure to tobacco-related regulations that influence their personal perceptions.
Without longitudinal evidence, it is incredibly difficult to identify these changes or understand how factors drive them, making it impossible to reflect the needs of older adult populations. Understanding these changes could potentially help public health professionals develop more targeted educational campaigns and policies that address tobacco use and risk perception within older adults.
Longitudinal studies could provide a more comprehensive review of understanding tobacco-related attitudes within this population in order to respond to health initiatives and circumstances. Addressing this potential gap could better inform tobacco control strategies that reflect the ever-changing needs and perspectives of older adults.
