Cigarette Smoking and Pulmonary Function in Adult Survivors of Childhood Cancer Exposed to Pulmonary-Toxic Therapy: Results from the St. Jude Lifetime Cohort Study

Oancea, S. Cristina; Gurney, James G.; Ness, Kirsten K.; Ojha, Rohit P.; Tyc, Vida L.; Klosky, James L.; Srivastava, Deokumar; Stokes, Dennis C.; Robison, Leslie L.; Hudson, Melissa M.; Green, Daniel M.

doi:10.1158/1055-9965.epi-14-0266

Cited by 17 publications

(16 citation statements)

References 22 publications

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“…These intervention studies highlight how difficult it is to meaningfully change long‐term smoking behavior, but the substantial number of CCSS survivors who self‐reported consistent current smoking in our analysis clearly calls for continued work in this area. A recent study demonstrating that even moderate smoking exposure negatively affected pulmonary function in a relatively young group of childhood cancer survivors (median age, 35 years) emphasizes the importance of early intervention …”

Section: Discussionmentioning

confidence: 99%

“…A recent study demonstrating that even moderate smoking exposure negatively affected pulmonary function in a relatively young group of childhood cancer survivors (median age, 35 years) emphasizes the importance of early intervention. 40 Notable strengths of our analysis include the large cohort of childhood cancer survivors, the wealth of data collected in the CCSS on demographic and treatment characteristics, the ability to examine the impact of chronic health conditions, and the collection of smoking status data at multiple points in time. A clear limitation is the reliance on self-reported smoking status.…”

Section: Discussionmentioning

confidence: 99%

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Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study

Gibson

Liu

Armstrong

et al. 2015

Cancer

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Background Survivors of pediatric cancer have elevated risks of mortality and morbidity. Many adverse late effects associated with cancer treatment (e.g. second cancers, cardiac and pulmonary disease) are also associated with cigarette smoking, suggesting survivors who smoke may be at high risk for these conditions. Methods We examined self-reported smoking status in 9,397 adult survivors of childhood cancer across 3 questionnaires (median time interval 13 years). Smoking prevalence among survivors was compared to siblings and expected prevalence based on age-, sex-, race-, and calendar time-specific U.S. population rates. Multivariable regression models examined characteristics associated with longitudinal smoking patterns across all three questionnaires. Results At baseline, 19% of survivors were current smokers, compared with 24% of siblings and 29% expected based on U.S. rates. Current smoking among survivors dropped to 16% and 14% on follow-up questionnaires, with similar decreases in siblings and expected prevalence. Characteristics associated with consistent never smoking included higher household income (relative risk 1.16, 95% confidence interval 1.08–1.25), higher education (1.32, 1.22–1.43), and receipt of cranial radiation therapy (1.08, 1.03–1.14). Psychological distress (0.86, 0.80–0.92) and heavy alcohol drinking (0.64, 0.58–0.71) were inversely associated. Among ever smokers, higher income (1.17, 1.04–1.32) and education (1.23, 1.10–1.38) were associated with quitting, whereas cranial radiation (0.86, 0.76–0.97) and psychological distress (0.80, 0.72–0.90) were associated with not having quit (0.85, 0.76–0.96). Development of adverse health conditions was not associated with smoking patterns. Conclusion Despite modest declines in smoking prevalence, the substantial number of consistent current smokers reinforces the need for continued development of effective smoking interventions for survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study

Gibson

Liu

Armstrong

et al. 2015

Cancer

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“…We extracted diagnosis‐ and treatment‐related variables from the SCCR (http://www.childhoodcancerregistry.ch): age at cancer diagnosis, cancer diagnosis, chemotherapy, radiotherapy, surgery, and hematopoietic stem cell transplantation (HSCT). We defined cardiac and/or pulmonary toxic therapy as having received any of the following: carmustine, lomustine, busulfan, bleomycin, anthracyclines, and radiotherapy to the chest because these treatments have been associated with cardiac or pulmonary late effects . We classified cancer diagnosis according to the International Classification of Childhood Cancer, third edition (ICCC‐3) into 12 main groups and LCH.…”

Section: Methodsmentioning

confidence: 99%

“…Smoking is particularly risky for vulnerable persons such as childhood cancer survivors. Eighty percent of survivors of childhood cancer treatment have serious late effects that include chronic pulmonary and cardiac diseases or secondary malignancies and smoking can worsen such outcomes . Although a recent meta‐analysis suggests that survivors of all age groups smoke less than matched peer controls (odds ratio, 0.5), prevalence of smoking in survivors remains high .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and reasons for smoking in adolescent Swiss childhood cancer survivors

Kasteler

Belle

Schindera

et al. 2018

Pediatric Blood & Cancer

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Background:Smoking harms health, particularly that of childhood cancer survivors, who face risk of pulmonary and cardiovascular diseases because of chemotherapy and radiotherapy to the chest. This nationwide study assessed smoking habits and reasons for smoking in adolescent survivors and healthy peers. Methods:As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to all Swiss resident survivors, who were aged 16-19 years. We compared smoking status and reasons for smoking between 511 survivors, 141 of their siblings, and 1,727 adolescents in a representative population-based study, the Tobacco Monitoring Switzerland (TMS).Results: Current smoking was less prevalent in survivors (17%) and their siblings (17%) compared with TMS (32%). Survivors and TMS adolescents gave similar reasons for smoking. Stress control, smoking being a habit, and good taste were the reasons for smoking cited most often in both groups. Peer smoking was more important in survivors (49%) than in TMS (34%, P = 0.004). Most important reasons for not smoking in both groups were smoking being unhealthy and not wanting to be addicted. Conclusions:In Switzerland, survivors smoke as often as their siblings but less than the general population. Peer smoking was a more important reason for smoking in survivors than in the general population, suggesting that reducing smoking in peers could result in a reduction of smoking in survivors. Overall, reasons for smoking were very similar, thus interventions to reduce smoking in survivors could be the same as those used in the general population.

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“…8, 9 RHBs may be even more problematic among childhood cancer survivors, already at increased risk for the development of chronic health conditions. 10 Among adult survivors, the prevalence of risky drinking (16.5%) 11 and smoking (17%) 12 is only slightly lower than the general population, and insufficient physical activity (46%) is higher. 13 Fortunately, RHBs are potentially modifiable.…”

Section: Introductionmentioning

confidence: 99%

Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Lown

Hijiya

Zhang

et al. 2016

Cancer

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Background Health complications related to childhood cancer may be influenced by risky health behaviors (RHBs), particularly when RHB co-occur. Limited information describes how RHBs cluster among childhood cancer survivors and siblings and the risk factors for co-occurring RHBs. Methods Latent class analysis was used to identify RHB clusters using longitudinal survey data on smoking, alcohol use, and physical activity from adult survivors (N=4184) and siblings (N=1598) in the Childhood Cancer Survivor Study (CCSS). Generalized logistic regression was used to evaluate associations between demographic characteristics, treatment exposures, psychological distress, health conditions, and cluster membership. Results We identified three RHB clusters: a low risk cluster; an insufficiently active cluster; and a high-risk cluster (tobacco and risky alcohol use and insufficient activity). Compared to siblings, survivors were more likely to be in the insufficiently active cluster (ORadj=1.17; 95% CI 1.06–1.27) and less likely to be in the high-risk cluster (ORadj=0.79; 95% CI 0.69–0.88). Risk factors for high-risk cluster membership included psychological distress, (ORadj=2.76; 95% CI 1.98–3.86) low educational attainment, (ORadj=7.49; 95% CI 5.15–10.88) income <$20,000, (ORadj=2.62; 95% CI 1.93–3.57) being divorced/separated or widowed, (ORadj=1.36; 95% CI 1.03–1.79) and limb amputation (ORadj=1.52; 95% CI 1.03–2.24). Risk factors for the insufficiently active cluster included chronic health conditions, psychological distress, low education or income, being obese or overweight, female sex, non-white race/ethnicity, single marital status, cranial radiation, and cisplatin exposure. Conclusions RHB co-occur in childhood cancer survivors and siblings. Economic and educational disadvantage and psychological distress should be considered in screening and interventions to reduce RHB.

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Cigarette Smoking and Pulmonary Function in Adult Survivors of Childhood Cancer Exposed to Pulmonary-Toxic Therapy: Results from the St. Jude Lifetime Cohort Study

Cited by 17 publications

References 22 publications

Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study

Longitudinal smoking patterns in survivors of childhood cancer: An update from the Childhood Cancer Survivor Study

Prevalence and reasons for smoking in adolescent Swiss childhood cancer survivors

Patterns and predictors of clustered risky health behaviors among adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

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