Factors Influencing Continued Smoking in Hypertensive Older Adults: The Need to Explore Social Welfare Factors

This study analyzed data from the 2019 Community Health Survey (n=40,944) to identify factors associated with continued smoking among hypertensive older adults aged 65 years and over with a history of smoking. Hierarchical logistic regression analysis showed that being male (OR=22.23, p<.001), having a spouse (OR=4.76, p=.006), and having a lower level of education (middle school or less) compared with high school or higher (OR=0.20, p=.004, indicating lower odds) were major factors related to continued smoking. Compared with those of normal weight, overweight (OR=0.11, p=.002) and obese (OR=0.24, p=.002) individuals had lower odds of continuing to smoke. Health and psychological factors such as age, income, employment status, sleep, depression, and stress were not significant, nor was satisfaction with the community socio-physical environment. Overall, continued smoking among older adults with hypertension was more strongly influenced by structural characteristics such as gender, education, and family relationships than by psychological or health-related factors, suggesting that smoking cessation policies should adopt an integrated approach linked to social welfare resources.