Patterns of Current Cigarette Smoking, Quit Attempts and Cessation Counseling among Survivors of Smoking-Related and Nonsmoking-Related Urological Malignancies: A Nationally Representative Cross-Sectional Analysis

Matulewicz, Richard S.; Basak, Ramsankar; Zambrano, Ibardo; Dearing, Bianca A.; Schatz, Daniel; El-Shahawy, Omar; Sherman, Scott E.; Bjurlin, Marc A.

doi:10.1097/ju.0000000000001483

Cited by 11 publications

(7 citation statements)

References 28 publications

(42 reference statements)

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“…It is critically important to identify all the risk factors associated with continuing to smoke in cancer patients to increase the effectiveness of tobacco cessation efforts. Some studies have investigated the factors associated with continuing to smoke after cancer diagnosis 12–16 . However, no previous studies have evaluated the relationship between continuing smoking after cancer diagnosis and cancer site by the medical or surgical specialty which primarily manages the disease.…”

Section: Introductionmentioning

confidence: 99%

Smoking status among cancer patients by medical specialty: A U.S. nationwide representative analysis

Nolazco,

Tang,

Alkhatib

et al. 2023

Cancer Medicine

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BackgroundPersistence in tobacco use among cancer survivors has been associated with a multitude of clinicodemographic factors. However, there is a paucity of understanding regarding the role the healthcare professional's specialty plays in tobacco cessation in tobacco‐related cancer survivors.MethodsWe conducted a cross‐sectional analysis of data from cancer survivors with a smoking history using the Behavioral Risk Factor Surveillance System (BRFSS) database to examine differences in the proportion of patients continuing tobacco use among patients with a diagnosis of cancer segregated by cancer site specialty over the 2016–2020 period. We accounted for complex survey design and used sampling weights to obtain a nationwide representative sample. We employed modified Poisson regression adjusting for age, gender, education, income, race, marital status, and medical specialty.ResultsWe analyzed 19,855 cancer survivors with a current or past history of tobacco use, of whom 5222 (26,3%) self‐reported to be current smokers. Patients with urological and gynecological tobacco‐related malignancies had a higher relative risk (RR) of being current smokers with a RR of 1.30 (95% confidence interval, 1.12–1.51) and 1.25 (95% confidence interval, 1.12–1.39) respectively. Malignant Hematology had the lowest RR of smoking status among all other specialties RR 0.85 (95% confidence interval, 0.59–1.21).ConclusionsContinuing smoking rates among tobacco‐related cancer survivors were different between specialties. One in four cancer survivors were current smokers; this emphasizes health professionals' paramount role in tobacco cessation counseling.

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Section: Introductionmentioning

confidence: 99%

Smoking status among cancer patients by medical specialty: A U.S. nationwide representative analysis

Nolazco,

Tang,

Alkhatib

et al. 2023

Cancer Medicine

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“…28 However, currently only a fifth of urologists offer any smoking cessation treatment to their patients with bladder cancer; evidence-based practices are routinely followed in fewer than 10% of patient encounters. 29,30 Given the myriad benefits of smoking cessation and the impact urologists can have, underutilization of evidence-based smoking cessation practices in the urology clinic remains a profound gap in care quality and a significant opportunity to improve outcomes for all bladder cancer patients. In addition, more attention should be paid to preventing smoking in young people and encouraging smokers to quit long before diagnosis to reduce the bladder cancer burden overall.…”

Section: Discussionmentioning

confidence: 99%

Association of Biochemically Verified Post-Diagnosis Smoking and Nonmuscle-Invasive Bladder Cancer Recurrence Risk

et al. 2022

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Purpose:Our goal was to determine the association between biochemically verified post-diagnosis smoking exposure and nonmuscle-invasive bladder cancer (NMIBC) recurrence risk.Materials and Methods:We conducted a prospective study of 354 NMIBC patients with a smoking history undergoing care between 2015 and 2018. Patients contributed at least 2 biospecimens during followup which were tested for cotinine to determine biochemically verified post-diagnosis smoking exposure (yes/no). Our primary endpoint was time to first recurrence after study start date. We examined whether post-diagnosis smoking exposure was associated with recurrence risk in multivariable Cox proportional hazards models that accounted for demographics, clinicopathological variables, time since diagnosis and pack-years.Results:Patients were predominantly White, male and had a median age of 68 years. Most patients had Ta disease (62%) and tumors of high grade (68%). Intravesical bacillus Calmette-Guérin was given to 63% of the cohort. Patients were followed for a median of 3.6 years since study start. Post-diagnosis smoking exposure was detected in 22% of patients, and 38.7% (137) of patients experienced a recurrence during followup. In multivariable models, only bacillus Calmette-Guérin treatment and prior recurrence rate were significantly associated with recurrence. There was no association between post-diagnosis smoking exposure and recurrence risk (HR: 0.73, 95% CI: 0.45–1.20).Conclusions:In a cohort of patients with predominantly high risk NMIBC, post-diagnosis smoking exposure was not associated with NMIBC recurrence. However, smoking cessation support remains a critical component of cancer care given that the benefits of quitting extend far beyond NMIBC recurrence.

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“…[3][4][5] However, persistent tobacco use after a urologic diagnosis such as kidney or bladder cancer remains high. 6 Quitting after a diagnosis can improve cancer, quality-of-life, and all-cause mortality outcomes. [7][8][9][10][11] Improving how and how often urologists help patients to quit tobacco will improve patient health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Using a multilevel implementation strategy to facilitate the screening and treatment of tobacco use in the outpatient urology clinic: A prospective hybrid type I study

Matulewicz

Bassett

Kwan

et al. 2021

Cancer

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BACKGROUND: Urologists frequently treat patients for tobacco-related conditions but infrequently engage in evidence-based practices (EBPs) that screen for and treat tobacco use. Improving the use of EBPs will help to identify smokers, promote cessation, and improve patients' health outcomes. METHODS: A prospective type I hybrid effectiveness-implementation study was performed to test the feasibility and effectiveness of using a multilevel implementation strategy to improve the use of tobacco EBPs. All urology providers at outpatient urology clinics within the Veterans Health Administration Greater Los Angeles and all patients presenting for a new urology consultation were included. The primary outcome was whether a patient was screened for tobacco use at the time of consultation. Secondary outcomes included a patient's willingness to quit, chosen quit strategy, and subsequent engagement in quit attempts. RESULTS: In total, 5706 consecutive veterans were seen for a new consultation during the 30-month study period. Thirty-six percent of all visits were for a tobacco-related urologic diagnosis. The percentage of visits that included tobacco use screening increased from 18% (before implementation) to 57% in the implementation phase and to 60% during the maintenance phase. There was significant provider-level variation in adherence to screening. Of all screened patients, 38% were willing to quit, and most patients chose a "cold turkey" method; 22% of the patients elected referral to a formal smoking cessation clinic, and 24% chose telephone counseling. Among those willing to quit, 39% and 49% made a formal quit attempt by 3 and 6 months, respectively. CONCLUSIONS: A strategy that includes provider education and a customized clinical decision support tool can facilitate provider use of tobacco EBPs in a surgery subspecialty clinic.

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Patterns of Current Cigarette Smoking, Quit Attempts and Cessation Counseling among Survivors of Smoking-Related and Nonsmoking-Related Urological Malignancies: A Nationally Representative Cross-Sectional Analysis

Cited by 11 publications

References 28 publications

Smoking status among cancer patients by medical specialty: A U.S. nationwide representative analysis

Smoking status among cancer patients by medical specialty: A U.S. nationwide representative analysis

Association of Biochemically Verified Post-Diagnosis Smoking and Nonmuscle-Invasive Bladder Cancer Recurrence Risk

Using a multilevel implementation strategy to facilitate the screening and treatment of tobacco use in the outpatient urology clinic: A prospective hybrid type I study

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