The Center for Social Gerontology 2307 Shelby Avenue
Ann Arbor, Michigan 48103-3895
734 665-1126 fax 734 665-2071
tcsg@tcsg.org
http://www.tcsg.org

SUMMARY OF FOCUS GROUP RESEARCH ON CURRENT & RECENT FORMER OLDER SMOKERS

Introduction

The Center for Social Gerontology, Inc. (TCSG), initiated a qualitative research study utilizing focus groups of current and recent former smokers aged 60 and over in order to obtain preliminary information on their motivations, opinions and behaviors about smoking and smoking cessation. To conduct this study, TCSG utilized Brogan & Partners, a national marketing firm based in Detroit with extensive experience in developing ad campaign to reduce tobacco use, who contracted with Performax, a Southfield, Michigan firm, to conduct focus groups of older persons in the Metro Detroit area. In November, 2001, Performax conducted four 90-minute focus groups, with each group consisting of a mix of men and women aged 60 and older; two groups consisted of older African-Americans, and two groups consisted of older Caucasians.

To the best of TCSG's knowledge, this is the first focus group study of older smokers and recent former smokers that has been done in the United States. The full report of this study is available on TCSG's web site at http://www.tcsg.org/tobacco/cessation.htm. The following is a summary of the key findings from these focus groups.

Summary of Key Findings & Conclusions

ATTITUDES, OPINIONS & BEHAVIORS RELATED TO SMOKING

Generally speaking, there were many similarities in the attitudes, opinions and behavior of the older persons in each of the four focus groups, despite differences in ethnicity, age, gender and current tobacco consumption patterns. Performax, which has conducted many focus groups of this type with younger persons, concluded that "this is an important general observation because it implies they may be treated as a single target segment in marketing and advertising communications, rather than separate sub-segments."

• In general, persons in all four focus groups started smoking at around the same age - the teen years.

• Various motivations were given for starting smoking, including: public persona/self-image (cool, glamorous, macho, etc.); curiosity as to what it would feel like to smoke; role modeling/peer pressure; environment encouraged smoking (it was the "in thing" and socially acceptable) [this is different from today's youthful smokers, who rarely mention this as a reason for starting to smoke]; physical and mental health (some people said they had been told by a doctor or friend to smoke to calm their nerves or calm an upset stomach) [this also is different from today's smokers, who mention health as a reason for not smoking, not for starting].

• Throughout the many years of smoking, they've varied the amount smoke. The variations are very similar to those expressed by persons in other age groups. Consumption increased during the following occasions or conditions: nervousness, stress/pressure, drinking coffee or alcohol, when in smoking environments or with other smokers, at casinos, and while driving. Consumption decreased, particularly, when the person has serious health problems. All of the smokers and former smokers know exactly how many cigarettes they smoke in an average day, and many monitor this very carefully, including rationing the number of cigarettes they smoke each day. A few persons try to control their consumption by seeking out non-smoking environments, such as the non-smoking sections of restaurants.

• Persons in all four focus groups expressed some degree of awareness about the risks, hazards, and consequences associated with tobacco products. Unlike younger smokers, older smokers concerns were primarily focused on their health, rather than the impact of their smoking on others. (Most of these persons have been diagnosed with one or more health conditions associated with smoking-caused diseases, including some life-threatening conditions. And, death due to smoke-caused diseases surfaced as a concern among all groups, with many mentioning parents, friends or relatives who had died of smoking-caused diseases.)

• The cost of cigarettes surfaced as a concern among only a few persons, although many mentioned that they buy discount brands or use coupons to offset price.

• Bottom-line: virtually everyone believes tobacco and cigarettes are toxic.

TOBACCO CESSATION ATTITUDES, OPINIONS & BEHAVIORS

All four focus groups were forthright in admitting their smoking addiction and could name specific benefits of quitting. The majority believed they could quit if they made up their minds to do so, but a few admitted doubts about their ability to successfully quit.

The majority of persons in all four groups had previously tried to quit, and the number of times varied from 1 to 10 or more times. A few said they had never tried to quit. Some said quit attempts resulted from hospitalizations or surgeries.

In talking about the barriers to quitting and their motives for quitting, persons in all four focus groups gave similar responses. In essence, what's perceived as a personal barrier to quitting today, later becomes a compelling motive or impetus to quit later. Clearly, thee were some factors that had significant influence on thoughts and behaviors, and other factors that were secondary and became important later to reinforce whatever decision they've made.

Key Decision Factor: HEALTH

Key impetus or motive to quit smoking: Desire to feel or become healthy. (All the ex-smokers said they quit for health reasons - being diagnosed with a condition caused by or worsened by smoking.)

Key barrier to quitting smoking: Feeling physically well.

Key influencer and information source: Doctors.

Key role for doctors with smokers: To educate the smoker about the specifics of how smoking will negatively effect their health, not just to say stop smoking, i.e., a more personal and individualized approach.

Key Decision Factor: DEATH

Key impetus or motive to quit smoking: All persons in the four groups talked about people they've known who died from a smoking-caused illness and said these were compelling reasons to quit.

Key Decision Factor: WILL POWER

Key impetus or motive to quit: Persons in four groups emphasized the importance of will power in quitting or being unable to quit successfully.

Key barrier to quitting: Most of the current smokers admitted they haven't quit because they haven't truly made up their minds to quit and/or they lack the will power currently to do it.

Key Decision Factor: ABILITY TO COPE

Key impetus or motive to quit: Persons in all four groups talked about their willingness to change their behavior as a key factor, i.e., developing and using coping techniques, self-discipline, seeking non-smoking environments, etc.

Key barrier to quitting: Persons in all four groups talked about being vulnerable and tempted to smoke when their were certain environmental influences, such as being under stress, around other smokers, or in settings where smoking is allowed.

Another key barrier to quitting: Fearing that they would fail in their attempt to quit.

Key Decision Factor: AWARENESS OF SMOKING CESSATION AIDES

Impetus or motive to quit: Many smokers and ex-smokers made the decision to quit because they were aware of specific types of aids available to help them, such as nicotine gum or the patch.

Key barrier to quitting: There were varying levels of awareness of cessation and nicotine reduction therapies available, with both groups of African-Americans being less aware of cessation aids than the Caucasian groups.

Another key barrier to quitting: Persons in all the groups expressed some concerns about the effectiveness of smoking cessation aids. The lack of information from doctors recommending or educating them about cessation aids was voiced as a barrier to trying them.

Factors Mentioned but Not as Important as Motivators to Quit

Persons in all four focus groups mentioned a number of other factors which played some role in their attempts to quit, but these seemed less significant than the factors described above. These factors included: 1) wanting to encourage a parent or spouse to also quit smoking; 2) being embarrassed by the smell of smoke on their clothes or hair; 3) awareness of the chemicals in cigarettes; 4) trying to please their children or grandchildren who wanted them to quit; and 5) knowing that secondhand smoke from their cigarettes effected others.

The factors mentioned above appeared to be less important as motivators because they did not have a direct effect which benefited the smoker. Therefore, these factors appeared to be more reinforcers of the decision to quit, rather than strong motivators by themselves to quit.

EXPOSURE TO TOBACCO CESSATION ADVERTISEMENTS

At the end of the focus groups, there was a short discussion about the media formats that should be used to reach them to encourage persons to quit. A number of radio ads were also played to determine key messages. The findings were as follows:

Persons in all four groups listed basically the same media formats that should be used to communicate smoking cessation messages, and television was identified as the best because they watch TV often and they pay attention to ads on TV.

Key message lines identified were: "Don't quit quitting." Also, "It's never too late to quit."

There was agreement among persons in all four groups that ads should focus on them as smokers, rather than the effects of secondhand smoke on others.

Like other age groups, older persons in the groups want hard-hitting ads with realistic information about the effects of smoking on the smoker's health and personal life. They also liked the idea of learning more about the ingredients in cigarettes and the types of specific damage these ingredients do to the body.

There was general agreement that the spokesperson in ads should be someone of their age who didn't quit and is suffering because of it or someone who quit successfully before it was too late.

People with oxygen tanks surfaced in several groups as very hard-hitting and as an effective way to encourage them to quit before they developed a similar condition.

People in a number of the focus groups suggested using someone who communicated a personal success story in quitting and who is sorry s/he didn't quit much sooner.

Ethnicity of the spokesperson was not found to be important, in spite of 2 focus groups being African-American and 2 Caucasian. However, gender made a difference to persons in a number of the groups.

While there was not unanimity, it appeared that using children as spokespersons would not be as effective as focusing on what the smoker is doing to his/her own health.

Many persons identified an ad which described toxic substances in cigarettes as being a very effective message, in part because it was new news to them and caught their attention. (Members of the focus groups asked Performax to provide them with a list of the toxic ingredients.)