Smoking-Related Social Interactions as Experienced by Persons Who Smoked Long-term

Draucker, Claire Burke; Rawl, Susan M.; Vode, Emilee; Fields, J. Matthew; Elkins, Candice; Morgan, Olivia; Pérez, Susana Moraleda; Straber, Lucy; Carter‐Harris, Lisa

doi:10.1097/nur.0000000000000555

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…Such communication efforts should aim to avoid stigmatizing smoking behaviors, an issue raised by participants in our study and found in previous research. 64,65 Our study also suggests that trust-building should entail efforts to acknowledge, understand, and reduce the present-day incidence of harmful patient experiences with practitioners.…”

Section: Jama Network Open | Oncologymentioning

confidence: 80%

Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors

Richmond,

Fernandez,

Bonnet

et al. 2024

JAMA Netw Open

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ImportanceScreening for lung cancer using low-dose computed tomography is associated with reduced lung cancer–specific mortality, but uptake is low in the US; understanding how patients make decisions to engage with lung cancer screening is critical for increasing uptake. Prior research has focused on individual-level psychosocial factors, but environmental factors (eg, historical contexts that include experiencing racism) and modifying factors—those that can be changed to make it easier or harder to undergo screening—also likely affect screening decisions.ObjectiveTo investigate environmental, psychosocial, and modifying factors influencing lung cancer screening decision-making and develop a conceptual framework depicting relationships between these factors.Design, Setting, and ParticipantsThis multimethod qualitative study was conducted from December 2021 to June 2022 using virtual semistructured interviews and 4 focus groups (3-4 participants per group). All participants met US Preventive Services Task Force eligibility criteria for lung cancer screening (ie, age 50-80 years, at least a 20 pack-year smoking history, and either currently smoke or quit within the past 15 years). Screening-eligible US participants were recruited using an online panel.Main Outcomes and MeasuresKey factors influencing screening decisions (eg, knowledge, beliefs, barriers, and facilitators) were the main outcome. A theory-informed, iterative inductive-deductive approach was applied to analyze data and develop a conceptual framework summarizing results.ResultsAmong 34 total participants (interviews, 20 [59%]; focus groups, 14 [41%]), mean (SD) age was 59.1 (4.8) years and 20 (59%) identified as female. Half had a household income below $20 000 (17 [50%]). Participants emphasized historical and present-day racism as critical factors contributing to mistrust of health care practitioners and avoidance of medical procedures like screening. Participants reported that other factors, such as public transportation availability, also influenced decisions. Additionally, participants described psychosocial processes involved in decisions, such as perceived screening benefits, lung cancer risk appraisal, and fear of a cancer diagnosis or harmful encounters with practitioners. In addition, participants identified modifying factors (eg, insurance coverage) that could make receiving screening easier or harder.Conclusions and RelevanceIn this qualitative study of patient lung cancer screening decisions, environmental, psychosocial, and modifying factors influenced screening decisions. The findings suggest that systems-level interventions, such as those that help practitioners understand and discuss patients’ prior negative health care experiences, are needed to promote effective screening decision-making.

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Section: Jama Network Open | Oncologymentioning

confidence: 80%

Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors

Richmond,

Fernandez,

Bonnet

et al. 2024

JAMA Netw Open

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“…27 This perceived-and possibly internalized stigma-may have consequences such as patients with tobacco-related cancers choosing to avoid or delay engaging in tobacco cessation services. [27][28][29] Depression or depressive symptoms are known barriers to cessation, and this appears generalizable to oncology patients. Indeed, a smoking cessation clinical trial found that patients with tobacco-related cancers reported significantly higher levels of depression than patients with non-tobacco-related cancers, 15 and this predicted smoking relapse.…”

Section: Discussionmentioning

confidence: 99%

Demographic and Clinical Predictors of Engaging in Tobacco Cessation Counseling at a Comprehensive Cancer Center

Rodgers-Melnick

Zanotti

Lee

et al. 2022

JCO Oncology Practice

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PURPOSE: To address challenges promoting tobacco cessation in oncology settings, it is important to understand characteristics associated with patient engagement in tobacco cessation treatment. This analysis examined predictors of participating in at least one tobacco cessation counseling session among patients referred to a comprehensive cancer center's Tobacco Intervention and Psychosocial Support (TIPS) service. METHODS: Patients with cancer who reported current smoking or recently quitting and referred to TIPS between June 2017 and February 2020 were included in the analysis. Independent variables included sex, race and ethnicity, insurance type, cancer diagnosis (tobacco-related or not), age, nicotine dependence, and cigarettes smoked per day at baseline. The outcome variable was completion of at least one tobacco cessation counseling session among those assessed by the TIPS program. Unadjusted and adjusted analyses tested associations between the independent variables and tobacco cessation counseling engagement. RESULTS: Of 360 oncology patients referred to the TIPS program, 224 (62.2%) were assessed and 120 (33%) engaged in at least one counseling session. After controlling for sociodemographics and tobacco use, the results demonstrated that patients diagnosed with tobacco-related cancers were 45.3% less likely to engage in the tobacco cessation program compared with those with non–tobacco-related cancers ( P = .041). CONCLUSION: Patients diagnosed with tobacco-related cancers were less likely to engage in TIPS. Additional therapeutic resources may be needed to engage these patients to address potential explanatory factors, such as stigma, guilt, and fatalism. More research is needed to explore the impact of a tobacco-related cancer diagnosis on treatment engagement.

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Smoking-Related Social Interactions as Experienced by Persons Who Smoked Long-term

Cited by 2 publications

References 20 publications

Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors

Patient Lung Cancer Screening Decisions and Environmental and Psychosocial Factors

Demographic and Clinical Predictors of Engaging in Tobacco Cessation Counseling at a Comprehensive Cancer Center

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