How Definitions of Tobacco-Product Cessation Shape Conclusions about Later-Life Quitting Behavior: Evidence from the Population Assessment of Tobacco and Health (PATH) Study
Year: 2026
Type: report
Abstract: BACKGROUND AND OBJECTIVES: Later-life cessation is usually summarized with one cigarette indicator, typically 30-day point-prevalence abstinence. That convention conflates quitting effort with achieved abstinence, fixes the denominator to current users, collapses a multi-product market into one product, and pools adults aged 55–64 with adults aged 65 and older. We ask whether the definition changes the age difference, and whether the two older strata differ. RESEARCH DESIGN AND METHODS: Pooled cohort-entry data from Waves 1, 4, and 7 of the Population Assessment of Tobacco and Health (PATH) Study were restricted to adults aged 18–24 (reference), 55–64, and 65 and older (N = 21,077; 52.3% female, 69.0% non-Hispanic White). Six cessation measures were built for six products: two on a current-use denominator (quit attempt; one-day abstinence) and four on an ever-use denominator (30-day, 6-month, and 12-36 month abstinence; self-identified quitting). Survey-weighted logistic models with replicate weights and multiple imputation yielded adjusted probabilities and risk differences. RESULTS: The sign of the age difference depended on the denominator. On current-use measures both older strata reported less quitting activity than young adults (one-day abstinence: −11.6 and −14.0 percentage points). On ever-use measures the direction reversed and the gap widened with the required duration, reaching +39.7 and +60.9 points for 12-month cigarette abstinence. Adults aged 65 and older exceeded those aged 55–64 for cigarettes (+21.3 points). DISCUSSION AND IMPLICATIONS: Conclusions about later-life cessation are properties of the definition as much as of the population. Aging cohorts should report both denominators in parallel, state the abstinence duration, and split adults aged 55 and older into 55–64 and 65-and-older strata.
Authors: Wang, Wenyi, Huang, Sijie, Cai, Qixin
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7211921838