A snapshot of smokers after lung and colorectal cancer diagnosis

Park, Elyse R.; Japuntich, Sandra J.; Rigotti, Nancy A.; Traeger, Lara; He, Yulei; Wallace, Robert B.; Malin, Jennifer L.; Zallen, Jennifer P.; Keating, Nancy L.

doi:10.1002/cncr.26545

Cited by 102 publications

(100 citation statements)

References 43 publications

(53 reference statements)

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“…One important explanation is that cancer diagnosis and treatment are often unappreciated by health professionals as a teachable moment for smoking cessation 3,15,16 . Cancer patients might try to quit, but are unable to do so independently or with limited support 7,17 . In our results, the similarity in smoking rates between current cancer patients and the non-cancer patient population could be attributable to high smoking relapse rates among cancer patients despite attempts to quit immediately after a cancer diagnosis 18,19 .…”

Section: Discussionmentioning

confidence: 99%

“…In our results, the similarity in smoking rates between current cancer patients and the non-cancer patient population could be attributable to high smoking relapse rates among cancer patients despite attempts to quit immediately after a cancer diagnosis 18,19 . Alternatively, cancer patients might believe that the damage has already been done and therefore quitting might not help them 7,17 . The type of cancer diagnosis can also influence a smoker's decision to quit.…”

Section: Discussionmentioning

confidence: 99%

“…The type of cancer diagnosis can also influence a smoker's decision to quit. For example, patients with lung, head, or neck cancers are more likely to quit smoking after their diagnosis 7,12 , possibly because physicians discuss smoking more with such patients or because the patients themselves can easily link their smoking habits with their cancer 7 . Patients with other types of cancer (for example, colorectal, breast, or prostate) might not see the link and might therefore have less motivation to quit 7,12 .…”

Section: Discussionmentioning

confidence: 99%

“…Smoking diminishes treatment effectiveness, particularly for radiation therapy and chemotherapy; it also exacerbates side effects, interferes with wound healing, and can be a risk factor for a wide range of pulmonary, cardiovascular, infectious, and woundrelated complications 3,4,[7][8][9] . Patients who smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Smoking Behaviours of Current Cancer Patients in Canada

et al. 2016

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Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada.Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011-2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population.There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Smoking Behaviours of Current Cancer Patients in Canada

et al. 2016

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“…[3][4][5] Estimates suggest that between 35% and 62% of cancer patients continue smoking in the year after diagnosis. [6][7][8][9][10][11] A cancer diagnosis motivates patients to attempt to quit smoking. 12 Physicians can improve motivation and the likelihood of achieving abstinence by offering assistance, including giving advice and prescribing medication.…”

Section: Introductionmentioning

confidence: 99%

Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Upper Aerodigestive Tract Cancer

et al. 2017

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PURPOSE Smoking cessation after a diagnosis of lung, bladder, and upper aerodigestive tract cancer appears to improve survival, and support to quit would improve cessation. The aims of this study were to assess how often general practitioners provide active smoking cessation support for these patients and whether physician behavior is influenced by incentive payments. METHODSUsing electronic primary care records from the UK Clinical Practice Research Datalink, 12,393 patients with incident cases of cancer diagnosed between 1999 and 2013 were matched 1 to 1 to patients with incident cases of coronary heart disease (CHD) diagnosed during the same time. We assessed differences in the proportion for whom physicians updated smoking status, advised quitting, and prescribed cessation medications, as well as the proportion of patients who stopped smoking within a year of diagnosis. We further examined whether any differences arose because the physicians were offered incentives to address smoking in patients with CHD and not cancer. RESULTSAt diagnosis, 32.0% of patients with cancer and 18.2% of patients with CHD smoked tobacco. Patients with cancer were less likely than patients with CHD to have their general practitioners update smoking status (OR = 0.18; 95% CI, 0.17-0.19), advise quitting (OR = 0.38; 95% CI, 0.36-0.40), or prescribe medication (OR = 0.67; 95% CI, 0.63-0.73), and they were less likely to have stopped smoking (OR = 0.76; 95% CI, 0.69-0.84). One year later 61.7% of patients with cancer and 55.4% with CHD who were smoking at diagnosis were still smoking. Introducing incentive payments was associated with more frequent interventions, but not for patients with CHD specifically.CONCLUSIONS General practitioners were less likely to support smoking cessation in patients with cancer than with CHD, and patients with cancer were less likely to stop smoking. This finding is not due to the difference in incentive payments. 2017;15:443-450. https://doi Ann Fam Med

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Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer

Park

Perez

Regan

et al. 2020

JAMA

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103

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IMPORTANCE Persistent smoking may cause adverse outcomes among patients with cancer. Many cancer centers have not fully implemented evidence-based tobacco treatment into routine care.OBJECTIVE To determine the effectiveness of sustained telephone counseling and medication (intensive treatment) compared with shorter-term telephone counseling and medication advice (standard treatment) to assist patients recently diagnosed with cancer to quit smoking. DESIGN, SETTING, AND PARTICIPANTSThis unblinded randomized clinical trial was conducted at Massachusetts General Hospital/Dana-Farber/Harvard Cancer Center and Memorial Sloan Kettering Cancer Center. Adults who had smoked 1 cigarette or more within 30 days, spoke English or Spanish, and had recently diagnosed breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma, or melanoma cancers were eligible. Enrollment occurred between November 2013 and July 2017; assessments were completed by the end of February 2018.INTERVENTIONS Participants randomized to the intensive treatment (n = 153) and the standard treatment (n = 150) received 4 weekly telephone counseling sessions and medication advice. The intensive treatment group also received 4 biweekly and 3 monthly telephone counseling sessions and choice of Food and Drug Administration-approved cessation medication (nicotine replacement therapy, bupropion, or varenicline). MAIN OUTCOME AND MEASURESThe primary outcome was biochemically confirmed 7-day point prevalence tobacco abstinence at 6-month follow-up. Secondary outcomes were treatment utilization rates. RESULTS Among 303 patients who were randomized (mean age, 58.3 years; 170 women [56.1%]), 221 (78.1%) completed the trial. Six-month biochemically confirmed quit rates were 34.5% (n = 51 in the intensive treatment group) vs 21.5% (n = 29 in the standard treatment group) (difference, 13.0% [95% CI, 3.0%-23.3%]; odds ratio, 1.92 [95% CI, 1.13-3.27]; P < .02). The median number of counseling sessions completed was 8 (interquartile range, 4-11) in the intensive treatment group. A total of 97 intensive treatment participants (77.0%) vs 68 standard treatment participants (59.1%) reported cessation medication use (difference, 17.9% [95% CI, 6.3%-29.5%]; odds ratio, 2.31 [95% CI, 1.32-4.04]; P = .003). The most common adverse events in the intensive treatment and standard treatment groups, respectively, were nausea (n = 13 and n = 6), rash (n = 4 and n = 1), hiccups (n = 4 and n = 1), mouth irritation (n = 4 and n = 0), difficulty sleeping (n = 3 and n = 2), and vivid dreams (n = 3 and n = 2). CONCLUSIONS AND RELEVANCE Among smokers recently diagnosed with cancer in 2 NationalCancer Institute-designated Comprehensive Cancer Centers, sustained counseling and provision of free cessation medication compared with 4-week counseling and medication advice resulted in higher 6-month biochemically confirmed quit rates. However, the generalizability of the study findings is uncertain and requires further research.

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A snapshot of smokers after lung and colorectal cancer diagnosis

Cited by 102 publications

References 43 publications

Smoking Behaviours of Current Cancer Patients in Canada

Smoking Behaviours of Current Cancer Patients in Canada

Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Upper Aerodigestive Tract Cancer

Effect of Sustained Smoking Cessation Counseling and Provision of Medication vs Shorter-term Counseling and Medication Advice on Smoking Abstinence in Patients Recently Diagnosed With Cancer

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