Dear Editor,
According to World Health Organization (WHO) report, there are 1.3 billion smokers in the world and smoking is responsible for approximately five million deaths all over the world every year (1). Smoking is a strong predictor of coronary heart disease (CHD) and mortality (2). The findings suggest that smoking might increase influenza-associated mortality risks among elders (3). In addition, elderly smokers are at risk of obesity and diabetes (4). Moreover, it is associated with total tooth loss (5). Smoking is also a risk factor for cancer (6). According to WHO, 14.2% of Iranian population, ranging between 15 and 64 are smokers (7). The current report is the result of the study with the aim of determinant prevalence of smoking and its related factors in the elderly in Kashmar, Iran, derived from a study conducted on aged population lifestyle.
In a cross sectional study carried out in 2011, 267 elderly people were selected by using stratified sampling method in Kashmar city, in the East of Iran. The samples were selected based on the number of the elderly covered under each health center. Data were obtained through interview by using a reliable and valid questionnaire. Data were analyzed by using SPSS software version15 with Chi-square and Fisher exact tests. Mean age of under-studied elderly was 69.03 ± 6.22 and the age range was 60 - 87 years old. 52.4% of the elderly were men and 2.6% of whom always smoked, 12.7% often, 9.4% sometimes, 14.6% rarely smoked and 60.7% of them never smoked. Smoking was significantly higher among men (P = 0.000), the elderly living alone (P = 0.038) and the elderly who had heart disease (P = 0.026). There was no significant association between smoking with diabetes (P = 0.227) and education level (P = 0.178).
Prevalence of smoking in the under-studied population is higher than other parts of Iran (8, 9), even higher than other neighborhood countries such as Turkey (10) and Pakistan (11). In contrast to studies by Zhu et al. and Husten et al. (12, 13) that smoking prevalence had no significant association with education level, that of our study showed relevance to low level of education in our participants. Elderly living alone smoked more in comparison to others. Loneliness is likely to be associated with mental problems such as mood disorders. Other studies carried out in this area indicated that depression in elders could be aggregated by smoking (14, 15). In line with heart disease, heart disease could be influenced by smoking; however, smoking is the main cause or aggravator for heart disease. In conclusion, our survey revealed that smoking prevalence in Kashmar is higher than not only other parts of Iran but also the neighborhood countries. Hence, we recommend appropriate research to figure out what causes smoking prevalence to be higher in elderlies, especially among the male who live alone. Due to the small size of the sample for the current study, more investigation in other parts of the country is required to identify the smoking prevalence and its related factors as well as appropriate interventions such as educational intervention and advocacy to decrease the prevalence of smoking among the elderly.
