Smoking withdrawal and relapse in head and neck cancer patients

Abstract

Background Smoking withdrawal and relapse were characterized among newly diagnosed head and neck cancer patients participating in a physician‐delivered smoking cessation intervention. Methods Patients completed questionnaires at baseline, 1, 6, and 12 months following intervention delivery. Results Significant baseline predictors of smoking relapse included medical treatment (XRT versus surgical treatment), stage of change/readiness to quit (precontemplators), age of initiation (younger), and greater addiction (smoking ⩽30 minutes after waking). Relapsers were significantly more likely to quit using gradual reduction versus cold turkey and had less confidence in remaining quit. Relapsers experienced significantly higher levels of anxiety and craving during withdrawal. Relapse was temporally delayed compared with healthy populations. Conclusion Assistance with cessation efforts should be ongoing for one year and should include nicotine replacement therapy and psychotropic medications to address significant relapse triggers. © 1999 John Wiley & Sons, Inc. Head Neck 21: 420–427, 1999.

Accuracy of self-reported tobacco use status among hematopoietic SCT patients

“…4, 5 Cotinine-verified relapse rates among other oncology patients range from 25–38% at 1-year post-treatment and 36.2–37.5% among heart transplant recipients. 21, 32–35 Taken with the current study, these studies suggest that relapse to tobacco use may be prevalent between the time of peak symptom burden and survivorship regardless of assessment method, though underestimated by self-report. Former use and active disease are associated with higher false negative rates in other populations, e.g.…”

Nicotine dependence and smoking habits in patients with head and neck cancer

“…These factors alone could contribute to patients experiencing anxiety or mood swings, or an exacerbation of these problems, which could add to or be mistaken for the withdrawal symptoms due to concurrent cessation of tobacco and (in many cases) alcohol use. ( 14 ) …”

“…Esses fatores por si só já poderiam contribuir para o surgimento ou exacerbação de quadros de ansiedade ou de alteração do humor, que poderiam ser adicionados ou confundidos com os sintomas de abstinência decorrentes da cessação simultânea do uso do tabaco e, muitas vezes, do álcool. ( 14 ) …”

Treating nicotine dependence and preventing smoking relapse in cancer patients

“…More salient predictors of failed smoking cessation or relapse include: younger age at which cancer patients started smoking [Waggoner, 2010; Schnoll, 2003, Gritz, 1999], concurrent symptoms or diagnosis of depression [Waggoner, 2010,; Berg, 2013; Pirl, 2004; Boyes, 2011; Martinez, 2009], second hand smoke exposure (e.g. from spouse, home, or workplace) [Waggoner, 2010; Kim, 2015; Kashigar, 2013; Eng 2014], decreased desire to quit [Waggoner, 2010, Schnoll, 2013, Park 2011], and concurrent alcohol use [Kim, 2015; Kashigar, 2013].…”

“…The majority of the relapse occurred in years 3 to 10 in this cohort. Head and neck cancer patients are expected to show a delay in smoking relapse beyond 1 month of cessation compared to their healthy counterparts who tend to relapse within 1 month of cessation [Gritz, 1993, 1999, & 2000]. Therefore, interventions should be developed and targeted to this critical period of relapse and prolonged for up to a year [Lee, 2008].…”