Does smoking abstinence predict cancer patients' quality of life over time?

Abstract

Objective Smoking cessation improves quality of life (QOL) in the general population. However, there is limited information on the role of smoking status on QOL among cancer patients. Moreover, previous studies tended to analyze smoking status dichotomously and at a single point in time, potentially reducing the strength of the relation between smoking cessation and QOL. This study examined the association of smoking abstinence and QOL over time, including depression, pain, and fatigue in patients with a wide variety of cancers. Methods Participants were 332 cancer patients (eg, gynecologic, breast, thoracic, head and neck, and genitourinary) who had been abstinent for at least 24 hours. Days abstinent and QOL were assessed at baseline and 2, 6, and 12 months later. Latent growth curve models examined if days abstinent was associated with QOL at each assessment. Baseline demographics (eg, sex and income) and smoking history variables (eg, nicotine dependence) were used as time‐invariant covariates. Results The final model for each QOL component had good‐to‐excellent fit. More days abstinent was associated with lower depression at all follow‐ups and with lower fatigue at 12 months but was not associated with pain. Conclusions QOL was better among patients who quit smoking for longer periods. Findings suggest different timelines, with smoking abstinence most immediately associated with lower depression, followed by lower fatigue. Although pain decreased over time, it was not associated with length of smoking abstinence. Results reinforce the relationship between sustained smoking cessation and QOL, which should be communicated to patients.

The Prognostic Impact of Quitting Smoking at or around Diagnosis on the Survival of Patients with Gastrointestinal Cancers: A Systematic Literature Review

“…By and large, in fact, any chance to obtain a gain in survival for cancer patients should not be dismissed, and this is all the more important in this setting when considering that the prognosis of gastrointestinal cancers is generally unfavourable, and actually frankly dismal for cancer of the pancreas, oesophagus, and liver. Moreover, stopping smoking has the potential to bring health benefits (besides the potential impact on the clinical course of gastrointestinal cancers) that are impossible to overestimate and include a sharp decrease in the risk of developing subsequent smoking-related illnesses (e.g., second primary tumours) and substantial improvements in the ability to cope with underlying diseases and in the overall quality of life [ 38 , 39 ]. Moreover, substantial improvements in cancer survivors’ quality of life might also be brought about by smoking cessation.…”

Smoking patterns and the intention to quit in German patients with cancer: study protocol for a cross-sectional observational study

“…17 18 In addition, smoking reduces cancer patients' reported quality of life (QOL), 19 20 with higher pain levels and fatigue, and those who quit smoking after cancer diagnosis experience a greater reduction in depressive symptoms. 20 Despite the growing evidence that smoking cessation after a cancer diagnosis is associated with more effective treatment and better prognosis, up to 60% of patients do not stop smoking after being diagnosed with cancer. 21 22 Interestingly, a Canadian study of patients with bladder cancer shows that also only up to 60% of patients with cancer are being informed by their doctors or nurses about the consequences of smoking during cancer treatment.…”

“… 17 18 In addition, smoking reduces cancer patients’ reported quality of life (QOL), 19 20 with higher pain levels and fatigue, and those who quit smoking after cancer diagnosis experience a greater reduction in depressive symptoms. 20 …”

“…Patients with head and neck cancer who continue to smoke were found to have an increased risk of developing a secondary primary tumour such as lung, oral cavity or a pharynx carcinoma 17 18. In addition, smoking reduces cancer patients’ reported quality of life (QOL),19 20 with higher pain levels and fatigue, and those who quit smoking after cancer diagnosis experience a greater reduction in depressive symptoms 20…”

Trajectory of smoking behaviour during the first 6 months after diagnosis of lung cancer: A study from Taiwan

“…However, this stopping‐smoking behaviour after a cancer diagnosis may not last; up to 60% of patients may return to regular smoking after completing treatment (Hopenhayn et al., 2013; Simmons et al., 2013). Continuous smoking after a diagnosis of cancer has been shown to have several negative impacts, including increased toxicity from treatment and decreased effectiveness of therapy (Waller et al., 2010), poor quality of life (Martínez et al., 2019) and shortened survival time (Fares et al., 2020; U.S. Department of Health & Human Services, 2020) . To develop an effective smoking cessation program and identify the best timing for intervention, it is essential to understand the changes or trajectories of smoking behaviour after the diagnosis of lung cancer and factors associated with different trajectories.…”