You're never too old to quit

Perhaps you’ve heard of the “damage is done” scenario. An elderly family member started smoking as a young person, maybe a teenager, tucking a pack of cigarettes into his rolled-up shirtsleeve or into her purse. Decades later, despite wall-to-wall anti-smoking ads, despite smoking being outlawed in nearly every public space, perhaps despite family pleas or doctors’ admonitions or even a heart attack, that person remains a smoker.

What’s the point of stopping now, he or she figures, when my body has already suffered the consequences of a lifetime of tobacco addiction? The damage is done, isn’t it?

So while the rate of smoking in those over age 65 is smaller — a bit over 8 percent — than it is in the younger population, more than 22 percent of whom smoke, older smokers are much less likely to try to stop. More than half of smokers ages 18 to 24 have tried to quit, the Centers for Disease Control and Prevention has reported, but only about a quarter of those over age 65 have. In the three decades following the first report by the surgeon general’s report on smoking and health in 1964, smoking rates dropped much more among younger adults than among older ones.

“They’ve been smoking longer, so they might be more nicotine-dependent,” said Bethea Kleykamp, a postdoctoral fellow in nicotine pharmacology at the National Institutes of Health, trying to explain those differences.

But in their article, “The Older Smoker,” recently published in The Journal of the American Medical Association, Dr. Kleykamp and Stephen Heishman, a nicotine researcher at the National Institute on Drug Abuse, argue that the damage isn’t done.

The good news for older smokers is that under the Affordable Care Act, Medicare now covers smoking-cessation counseling for any beneficiary who wants to stop. A quarter of older smokers have already made an attempt. (Previously, Medicare covered such programs only for those who already had a smoking-related disease.)

And Part D drug plans cover medications — patches, gum, pills — in most states. “We know that the best treatment is a combination of pharmacology and counseling,” Dr. Kleykamp said. You’d think that reducing smoking among the elderly population would save Medicare a boatload of money.