Who tended to continue smoking after cancer diagnosis: the national health and nutrition examination survey 1999–2008

Abstract

BackgroundIt has been estimated that there are approximately 12 million cancer survivors in the United States. Continued smoking after a cancer diagnosis is linked to adverse effects among cancer survivors on overall survival, treatment effectiveness, and quality of life. Little is known about who is more likely to quit smoking after his/her cancer diagnosis. The objective of this study is to evaluate factors associated with smoking cessation in cancer survivors, which to date has not been well studied.MethodThe National Health and Nutrition Examination Survey (NHANES) 1999–2008 surveys were used in this study. A total of 2,374 cancer survivors aged 20 and over with valid smoking status in the NHANES 99–08 survey were included in this study. Among them, 566 cancer survivors who regularly smoked at the time of their cancer diagnosis were included in the analyses.ResultsAround 50.6% of cancer survivors smoked regularly prior to their cancer diagnosis and only 36.1% of them quit smoking after their cancer diagnosis. Racial disparity was observed in smoking cessation among cancer survivors. Hispanics (OR = 0.23, 95% CI = 0.10-0.57) were less likely to quit smoking than Whites after their cancer diagnosis.ConclusionTwo-thirds of cancer survivors continued smoking after cancer diagnosis. Our study observed that the high risk group of continued smokers among cancer survivors is made up of those who are female, younger, Hispanic, with longer smoking history, underweight or with normal weight and without smoking-related cancer. These findings suggest that smoking cessation for cancer survivors should target on the high risk subgroups.

Smoking Behaviours of Current Cancer Patients in Canada

“…About 20% of current cancer patients in Canada are smokers. Similar conclusions have been reached in other studies showing that 20%-30% of cancer patients continue to smoke after their diagnosis [12][13][14] .…”

Hemispheric side of damage influences sex-related differences in smoking cessation in neurological patients

“…For smokers in an otherwise healthy population, females are less likely to try to quit smoking and more likely to relapse after trying to quit (Perkins, 2001; Piper et al, 2010; Ward, Klesges, Zbikowski, Bliss, & Garvey, 1997; Wetter et al, 1999). Literature is mixed regarding the sex-specific patterns of smoking cessation after diagnoses of a life-threatening illness (e.g., stroke, chronic obstructive pulmonary disease, and cancer) with support for equivalent, higher, and lower quit rates in males than females (Bak et al, 2002; Berg et al, 2013; Redfern, McKevitt, Dundas, Rudd, & Wolfe, 2000; Tashkin et al, 2001; Tseng, Lin, Moody-Thomas, Martin, & Chen, 2012). …”

Prevalence and Correlates of Smoking and Cessation-Related Behavior among Survivors of Ten Cancers: Findings from a Nationwide Survey Nine Years after Diagnosis

“…For example, in a study of 566 individuals from the National Health and Nutrition Examination Survey (NHANES; ref. 7), cross-sectional analyses found that the likelihood of (self-reported) smoking post-diagnosis was associated with being female, younger, Hispanic, underweight or normal weight, and not having a smoking-related cancer. Other studies have corroborated findings regarding female gender (15) and younger age (15) and also documented lower income and/or education (16) and type of cancer (17) as predictors of quitting smoking post-diagnosis.…”

“…Yet a significant proportion of cancer survivors continue to smoke tobacco post-diagnosis (3)(4)(5)(6)(7). Population-based, cross-sectional surveys estimate that between 15% and 18% of cancer survivors currently smoke (8)(9)(10)(11), but prevalence varies by type of cancer diagnosis (9,10) and is higher among younger survivors (8,10) and those diagnosed with smokingrelated cancers (11).…”