Table 3. Review of studies on smoking in the elderly.
| Studies | Quality assessment | Summary of findings | Quality | |||||||||
| Ref | N | Study design |
Limitations | Inconsistency | Indirectness | Imprecision | Publication bias |
Relative effect estimates | Absolute effect estimates |
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| CI: confidence Interval; COGTEL: Cognitive Telephone Screening Instrument; COPD: chronic obstructive pulmonary disease; CS: cohort study; CV: cardiovascular; CVD: cardiovascular disease; COGTEL: Cognitive Telephone Screening Instrument; COPD: chronic obstructive pulmonary disease; EXS: exsmokers; HR: Hazard ratio; I: Important; m: men;NA: no applicable; NS: non smoking; OBS: observational study; OR: odds ratio; RCT: random clinical trial; Ref: bibliography reference annex 1; RR: relative risk; RV: Review; S: smokers; SR: systematic review; U: Undetected; UV: unavailable; VI: very important; QALY: quality-adjusted life year; Quality: quality assessed according to GRADE methodology; w: women. | ||||||||||||
| Does smoking affect cardiovascular disease in the elderly? | ||||||||||||
| 21 | 1 412 749 | CS | U | I | NA | I | U |
HR 1.48 (95% CI. 1.15-1.90) (angina and acute coronary syndrome) |
UV | Low | ||
| 22 | 8 807 | CS | U | I | NA | I | U | HR 2.25 (CI 95%; 1.05-4.81) (NS. 50-59years) HR 0.9 (0.63-1.29) (NS. 60-74years) |
UV | Low | ||
| Does smoking affect quality of life in the elderly? | ||||||||||||
| 23 | 3 652 | CS | U | I | NA | U | U | -3.5 QALY (EXS) vs -8.8 QALY (NS) | UV | Low | ||
| 24 |
382 |
CS |
I |
U |
NA |
U |
U |
Physical problems (carrying, climbing stairs, and walking) OR (3.71-6.6-2.34) (NS) OR (7.32-3.39-3.74) (NS <10years) OR (4.53-3.35-2.66) (NS >11years) |
UV | Very low | ||
| Does smoking affect cognition in the elderly? | ||||||||||||
| 25 | UV | RS | U | I | NA | U | U | S vs EXS-NS: Alzheimer 1.59 (1.15-2.2) vs 0.99 (0.81-1.23) Vascular dementia 1.35 (0.9-2.02) vs 1.05 (0.72-1.54) Inespecific dementia 1.16 (0.9-1.5) vs 0.9 (0.75-1.07) Cognitive decline 1.2 (0.9-1.59) vs 0.9 (0.74-1.1) |
UV | High |
||
| 26 | 1 697 | CS | I | U | NA | U | U | COGTEL -0.31 pts (-0.51.-0.11) (20 pack/year) COGTEL -2 pts (-3.59; -0.4) (S vs NS) |
UV | Low | ||
| Does smoking affect mortality in the elderly? | ||||||||||||
| 27 | UV | SR | I | I | NA | U | U | Relative mortality: 1.83 (95% CI 1.65-2.03) (S vs NS) vs 1.34 (1.28-1.34) (EXS vs NS) |
UV | Low | ||
| 28 | 13 030 | CS | U | U | NA | I | U | Relative mortality: 2.61 (95%CI 2.15-3.18) (S vs Ns) Relative mortality CVC: 2.67 (1.92-2.67) and 1.95 (1.33-2.86) (m 45-64 and 65-74 years) vs 4.28 (2.29-7.99) and 2.67 (1.28-5.58) (w 45-64 and 65-74) Cancer: 3 (2.15-4.18) and 4.5 (2.82-6.10) (NS m 45-64 and 65-74 years) vs 2.27 (1.64-3.44) and 4.45 (2.5-7.93) (NS. w. 45-64 and 65-74 years) |
UV | High | ||
| 29 | 478 248 | CS | U | I | NA | U | U | CVD mortality: HR 1.82 (1.45-2.28) (NS 40 years) HR 0.96 (0.67-1.38) (NS 80 years) Non-CVD mortality: HR 1.69 (1.57-1.82) (NS 50 years) HR 1.4 (1.17-1.69) (NS 80 years) |
UV | Low | ||
| 30 | 503 905 | CS | I | VI | NA | U | U | CVD mortality: HR 2.07 (CI 95% 1.38-2.39) (NS) Acuye coronary syndrome: HR 1.98 (1.75-2.25) (NS) vs HR 1.18(1.06-1.32) (NS/ EXS) stroke: HR 1.58 (1.4-1.78) (NS) vs HR 1.17 (1.07-1.26) (NS/ EXS) |
UV | High | ||
| Is it beneficial to quit smoking in older people? | ||||||||||||
| 31 | 267 010 | OBS | I | U | NA | U | U | COPD risk hospitalization: HR 6.81 (CI95%: 5.87-7.89) (NS/ EXS) General risk hospitalization: HR 0.84 (95% CI. 0.82-0.86) 16% (c/10 years smoking cessation) |
UV | Low | ||
| 32 | 95 683 | CS | I | I | NA | I | U | Stroke (NS/ EXS): RR 1.39 (95%CI 1.13-1.70) (m) vs RR 1.65 (1.21-2.25) (w) Acute coronary syndrome (NS/ EXS): RR 1.6 (1.39-1.84) (m) vs RR 3.35 (2.23-5-02) (w) CVD total (NS/ EXS) RR 1.60 (1.39-1.84) (m) vs RR 2.06 (1.69-2.51) (w) |
UV | Low | ||
| 33 | 877 243 | CS | I | VI | NA | U | U | Mortality (NS): RR 2.43 (2.21-2.48) (m) vs RR 1.68 (1.56-1.8) (w) Mortality (NS 3-5 years): RR 1.29 (0.88-1.69) (m) vs RR 1.55 (1.17-1.93)(w) |
UV | High | ||
| Are smoking cessation interventions effective in the elderly? | ||||||||||||
| 34 | 470 | RCT | I |
U | U | VI | U |
88% vs 82% (try to smoking cessation 6 months) 40% vs 33 % (p<0.05) (smoking cessation 6 months) 88% vs 82% (p<0.05) (try to smoking cessation 12 months) 33% vs 31% (smoking cessation 12 months) |
UV | Low | ||
| 35 | 177 92 (in treatment group) |
RCT | I | U | U | I | U | OR 2.24 (CI 95%; 1.07-4.69) (w) | UV | Low | ||
| 36 | 1 553 1 016 (in treatment group) |
RCT | I | U | U | VI | U |
OR 1.1 (0.7-1.8) (control vs therapy 1) vs OR 1.7 (1.1-2.6) (control vs therapy 2) |
UV | Low | ||
| 37 | 315 (in treatment group) | CS | U | U | NA | VI | U | HR 0.74 (CI 95%; 0.6-0.92) | UV | Low | ||