Can Cancer Diagnosis Help in Quitting Tobacco? Barriers and Enablers to Tobacco Cessation Among Head and Neck Cancer Patients from a Tertiary Cancer Center in South india

Mathew, Bincy; Vidhubala, E; Sundaramoorthy, C.

doi:10.1177/0253717620930317

Cited by 6 publications

(9 citation statements)

References 39 publications

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“…These rates are similar to previous reports,[ 4 ] specifically from India. [ 15 ] The encouraging fact is that >85% of patients have attempted to quit after the diagnosis and show willingness to quit in near future. Although advised routinely in cancer clinics to quit SLT use, a more formal and structured SLT cessation sessions might help them better.…”

Section: Discussionmentioning

confidence: 99%

“…Mathew et al . (2020),[ 15 ] a recent study from India, qualitatively identified factors associated with quitting successfully and continued use in patients with HNC. While perceived benefits of quitting and advice from the physicians were reported as reasons to quit, poor coping and nihilistic attitude regarding cancer outcomes were reported as reasons for continues use; awareness about cancer and its association with tobacco and a lack of it were positively and negatively associated with quitting.…”

Section: Discussionmentioning

confidence: 99%

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Impact of cancer diagnosis on use of smokeless tobacco: A descriptive study of patient-relative dyads

Shukla

Tikka

Singh

et al. 2022

Indian J Psychiatry

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Background: The time of cancer diagnosis is considered as a teaching moment with regard to tobacco cessation. Aim: In view of the limited studies focussing on smokeless tobacco (SLT), we aimed to assess the patterns of SLT use, attitudes toward SLT use in the context of cancer diagnosis, and factors associated with quitting SLT in dyads consisting newly diagnosed patients with head and neck cancers and their relatives. Material and Method: A total of 106 such dyads were assessed on cross-sectional study design. The patients included in the study were above 18 years of age of either sex with a recent (i.e., <6 months) diagnosis of head and neck (lip, tongue, mouth, oropharynx, hypopharynx, pharynx, and larynx) cancer (HNC), not having undergone any surgical intervention for the same and having used SLT for at least 6 months continuously prior to diagnosis of HNC. For each patient, one family member who was aged 18 years or above and lived for at least past 1 year with the patient was included. Result: We found that 60.4% of patients and 6.53% of relatives quit SLT use after the diagnosis of cancer. However, motivation to quit was greater despite continued SLT use, in both patients and relatives. Reasonable number of patients and relatives reported awareness regarding health warnings and long-term consequences of SLT use on cancer. For patients, use of only one form of SLT, presence of 2 or more males in the family using SLT, and presence of another tobacco-related medical disorder in the family were significantly higher in those who quit. Conclusion: The diagnosis of cancer might indeed act as a “teaching moment” for many users but this effect is not extendable on to their relatives.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of cancer diagnosis on use of smokeless tobacco: A descriptive study of patient-relative dyads

Shukla

Tikka

Singh

et al. 2022

Indian J Psychiatry

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“…Conlon et al 6 conducted a survey of 493 patients with newly diagnosed HNSCC and a history of smoking, 183 of whom were current smokers. Of the current smokers, 157 (85.8%) were currently 7 found that among active and former smokers with HNSCC, the primary self-reported motivations to quit were perceived benefits of quitting, advice from their physicians, and awareness of the association between tobacco and cancer. The authors also found continued smoking to be associated with coping mechanisms, nihilistic perception of the prospects of their cancer care, and poor understanding of the association of cancer and tobacco.…”

Section: Discussionmentioning

confidence: 99%

“…The authors also found continued smoking to be associated with coping mechanisms, nihilistic perception of the prospects of their cancer care, and poor understanding of the association of cancer and tobacco. 7 Their findings suggest that smokers with HNSCC are interested in quitting and motivated to quit at the time of diagnosis of HNSCC, most often because they understand the health implications of continuing to smoke. Effects of treatment on the enjoyment or ease of tobacco use are another potential explanation for the higher tobacco use cessation rates in the first 6 months after treatment.…”

Section: Discussionmentioning

confidence: 99%

Persistent Tobacco Use After Treatment for Head and Neck Cancer

Heest

Rubin

Khariwala

2022

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Smoking during and after treatment has been linked to increased morbidity and mortality in patients with head and neck squamous cell carcinoma (HNSCC). Posttreatment tobacco use patterns and the appropriate timing for cessation interventions are understudied.OBJECTIVE To determine the frequency and patterns of posttreatment smoking cessation in smokers with HNSCC. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study assessed smoking status after a new diagnosis of HNSCC among daily smokers who were treated at a tertiary care center at an academic institution between January 1, 2009, and December 31, 2017. EXPOSURES Being current daily cigarette smoker at the time of diagnosis of HNSCC and having smoked at least 5 cigarettes per day for at least 5 years. MAIN OUTCOMES AND MEASURES Patients provided data indicating smoking intensity, duration of tobacco use, number of cessation attempts, number of successful cessation days, and symptoms during cessation attempts, as well as demographic and clinical information at the time of diagnosis, as well as smoking and disease status at 6 months, 12 months, 18 months, and 24 months after treatment. RESULTS Eighty-nine smokers with HNSCC (mean [SD] age at enrollment, 60.1 [9.2] years; 74 [83.1%] male and 15 [16.9%] female; 2 [2.2%] American Indian or Alaska Native, 1 [1.1%] Asian, 3 [3.4%] Black, 71 [79.8%] White, and 12 [13.5%] of unknown race and ethnicity or whose race and ethnicity were not reported) completed 24 months of posttreatment follow-up and were included in the study. Fifty-two patients (58.4%) continued to smoke at 6 months after treatment, 47 patients (52.8%) smoked at 12 months after treatment, 41 patients (46.1%) smoked at 18 months after treatment, and 40 patients (44.9%) smoked at 24 months after treatment. The probability of smoking cessation was highest during the first 6 months after treatment, at 0.36. Mean (SD) number of cigarettes per day (17.8 [9.6] vs 12.4 [10.0], mean difference, 5.1 [95% CI, 0.2 to 10.6]), duration of tobacco use (28.2 [18.1] vs 16.4 [17.4] years, mean difference, 11.8 [1.9 to 21.7] years), and lower number of prior quit attempts (5.3 [5.9] vs 10.4 [22.9], mean difference, −5.2 [95% CI, −15.7 to 5.4]) were all associated with persistent tobacco use at 24 months after treatment vs those who successfully quit. CONCLUSIONS AND RELEVANCEThe results of this cohort study suggest that a significant proportion of patients with HNSCC who are daily smokers at the time of diagnosis continue to smoke after treatment. Smokers with HNSCC who successfully quit smoking were most likely to do so in the first 6 months after treatment, which could potentially serve as a preferred window for smoking cessation interventions. These data highlight the need for inclusion of aggressive smoking cessation intervention in head and neck cancer care pathways.

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“…Recent study suggested that even after being diagnosed with Head and Neck Cancer, one third of the study population continued to use tobacco. [ 15 ] Thus, it becomes an integral part of health professionals to provide a structured approach to initiate smoking cessation, manage withdrawal symptoms, and provide long-term support. [ 16 ] However, these cessation programs are usually customised according to individuals.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on attitude towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status

Chellappa

Balasubramaniam

Indiran

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: Tobacco consumed as smoke and smokeless forms is an important preventable public health issue projected to be the single largest cause of mortality worldwide. The aim of the study was to qualitatively assess the attitudes towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status. Materials and Methods: An in-depth interview for 10 current smokers and a focus group discussion comprising of 10 current smokers was conducted with a guide and moderator which was audio recorded. About 6, 8 and 6 subjects from white collar, blue collar, and black collar employee status participated in the study. Their tobacco consumption and dependence using the Fagerstrom Test for Nicotine Dependence scale (FTNDS) was assessed. Results: About 50% of the participants had low; 30% had moderate and 20% had high nicotine dependency. Most of the participants started smoking by peer influence and continued as it made them to socialize. Relapses during their quit attempt was mainly due to work stress. Participants heard about the control of tobacco act but were unsure of the features in it. They perceived that no changes will happen if government bans production and selling of tobacco products. Also anti-tobacco commercials in social media will have no use. Nicotine replacement therapy may help in quitting the habit. Conclusion: The study concluded that people in low socio-economic status had high nicotine dependency with inadequate knowledge on tobacco control policies. They strongly believe that an individual's self-restrain only can succeed him in quitting the habit.

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Can Cancer Diagnosis Help in Quitting Tobacco? Barriers and Enablers to Tobacco Cessation Among Head and Neck Cancer Patients from a Tertiary Cancer Center in South india

Cited by 6 publications

References 39 publications

Impact of cancer diagnosis on use of smokeless tobacco: A descriptive study of patient-relative dyads

Impact of cancer diagnosis on use of smokeless tobacco: A descriptive study of patient-relative dyads

Persistent Tobacco Use After Treatment for Head and Neck Cancer

A qualitative study on attitude towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status

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