A Qualitative Study of Smoking‐Related Causal Attributions and Risk Perceptions in Cervical Cancer Survivors

Abstract

Objective The prevalence of smoking among cervical cancer survivors typically exceeds what is found among women in the general population and other cancer survivors. Yet, there is a dearth of literature on risk and protective factors related to smoking among cervical cancer survivors, especially when it comes to identification of variables that are amendable to intervention. To help fill this gap in the literature, this qualitative study examines the nature of smoking‐related causal attributions and risk perceptions in cervical cancer survivors who smoked at cancer diagnosis. Methods Participants are 21 female cervical cancer survivors (M=45.7, SD=8.4 years old), all diagnosed in the past five years. Nearly three‐quarters of participants reported smoking in the past month. Results: Smoking was not uniformly recognized as a cause of cervical cancer (whether in general or participants' own cancer); the link between smoking and lung, head‐neck, and other cancers was more readily accepted. Despite generally weak endorsements of causal attributions, many participants reported smoking significantly increases risk for poor clinical (e.g., recurrence) and quality of life (e.g., pain) outcomes after cervical cancer diagnosis. Conclusions Findings suggest cervical cancer survivors may not fully understand or appreciate the role of smoking in cervical cancer risk whereas their beliefs about the role of smoking in cervical cancer prognosis are more well‐formed. This study highlights the potential role of causal attributions and risk perceptions in understanding and addressing the smoking‐related experience of cervical cancer survivors.

A descriptive study of cervical cancer survivors’ persistent smoking behavior and perceived barriers to quitting.

“…The results indicate that some potential obstacles to overcome are low motivation to quit and pessimistic beliefs about one’s ability to do so successfully. Other studies have found CCS and those with cervical dysplasia do not understand or appreciate fully the potential causal link between smoking and their (pre)cancerous condition or the risks of continued smoking on their future health (Costanzo et al, 2005; Hoover et al, 2019; Puleo et al, 2020). In addition, there is evidence rural cancer survivors have lower levels of health literacy than their nonrural counterparts (McDougall et al, 2018), which might be a factor here given the high number of rural-dwelling CCS.…”

“…The methods of this embedded mixed-methods study, including the eligibility criteria, recruitment strategy, and enrollment procedures are described in detail elsewhere (Puleo et al, 2020) and are only summarized here. Briefly, the quantitative aspect of the study allowed comprehensive measurement of key behavioral variables that have yet to be fully described in the literature (e.g., cigarettes per day, quit attempts) while the qualitative aspect of the study involved open-ended questions meant to uncover what variables CCS believe contribute to smoking and undermine quitting.…”

Implementation and evaluation of a smoking cessation checklist implemented within Australian cancer services

“…The timing of referral to a smoking cessation service could be more effective at a time-point other than the initial consultation. The highest quit attempts occur within the 12-months post-diagnosis and rates continued but decline after diagnosis according to an Australian study of 3315 mixed cancer-type patients 30 . The eMR flagging system allowed HCPs to re-assess cessation, which is considered an important step given that a patient's motivation to quit can be prolonged 31 .…”

The Appalachian Career Training in Oncology (ACTION) Program: Preparing Appalachian Kentucky High School and Undergraduate Students for Cancer Careers

“…Topics of these scholarly articles include a range of topics that illustrate the diversity of experiences occurring through the program. Publication topics include the relationship between body composition and immunity (Al-Attar et al, 2018), prostate cancer biology Hensley et al, 2019), colorectal cancer biology (Gan et al, 2020;Stevens et al, 2018;Xiong et al, 2020), nutritional programs (Weber et al, 2021), health insurance literacy in colorectal cancer survivors (Edward et al, 2021), smoking-related cervical cancer (Borger et al, 2021;Puleo et al, 2020), novel xenograft methods (Haney et al, 2020), neuroendocrine tumors (Chow et al, 2021), and T Cell biology (Presnell et al, 2020).…”