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Smoking habits persisted among cancer survivors
Nearly one-tenth of cancer survivors continued to smoke 9 years after diagnosis, according to results of a population-based study.
Among that group, 83% were categorized as daily smokers, and they smoked an average of 14.7 cigarettes per day, results showed.
“Cigarette smoking decreases the effectiveness of cancer treatments, increases the probability of recurrence and reduces survival time. Yet, a significant proportion of cancer survivors continue to smoke tobacco post-diagnosis,” researcher Lee Westmaas, PhD, director of tobacco research at the American Cancer Society, and colleagues wrote. “Population-based, cross-sectional surveys estimate that between 15% and 18% of cancer survivors currently smoke, but prevalence varies by type of cancer diagnosis, and [it] is higher among younger survivors and those diagnosed with smoking-related cancers.”
Westmaas and colleagues used nationwide cancer registries to identify a random sampling of 2,938 survivors of 10 different cancers. Researchers performed cross-sectional analyses to assess prevalence and correlates of smoking and smoking patterns among those survivors.
Results showed smoking prevalence varied considerably by cancer type, with highest rates observed among survivors of bladder (17.2%), lung (14.9%) and ovarian (11.6%) cancers. Researchers also observed elevated smoking prevalence among survivors of melanoma (7.6%), kidney cancer (7.3%) and colorectal cancer (6.8%).
“The finding of these levels of smoking among survivors with bladder and lung cancer is reason for concern,” Westmaas and colleagues wrote. “Post hoc analyses indicated that most bladder (90%) and lung cancer survivors (85%) were daily smokers who smoked a median of 10 or more cigarettes per day.”
Researchers noted that current smoking was linked to younger age, lower education and lower income, as well as greater alcohol consumption.
In addition, according to patient surveys, 40% of smokers reported that they planned to quit within the next month, but researchers found this objective was reduced among survivors who were married, older or smoked more frequently. Survivors diagnosed with smoking-related cancers were more likely to quit smoking following their initial diagnosis.
“Smoking is addictive, and having cancer does not guarantee that you will stop, even if that cancer was directly tied to your smoking,” Westmaas said in a press release. “We need to follow up with cancer survivors long after their diagnoses to see whether they are still smoking and offer appropriate counseling, interventions and possible medications to help them quit,”
Disclosure: The researchers report no relevant financial disclosures.
Perspective
Back to TopContinuing to smoke after a cancer diagnosis seems to defy logic. After such a scare, you would think a person would certainly stop smoking. Unfortunately, this rationale ignores an essential concept of tobacco use — addiction. Many health professionals do not understand the power of addiction. Walk outside a local cancer center and see a patient with IV pole in hand smoking a cigarette to get a visual depiction of addiction. By definition, it involves continuing to perform a known harmful behavior, but being unable to stop doing it. Tobacco is one of the most addictive substances in our society. It is more addictive than cocaine or heroin. Just knowing it is bad for you, even if you now have lung cancer, is often insufficient by itself to successfully stop.
What will make a difference is offering proven and effective tobacco treatments. Cancer centers have numerous reasons to provide tobacco treatment: 1) They are not only in the business of treatment but also cancer prevention. No single intervention can prevent more cancer deaths than smoking cessation; 2) Cancer treatments are less effective if a patient continues to smoke. In order to achieve the best outcomes for patients, providers should help them quit; and 3) NCI has encouraged tobacco treatment to be included into comprehensive cancer care.
Providers and cancer centers need to remember that tobacco is an addiction, not just a bad habit. Effective treatments exist, and they need to be funded and utilized. Our patients with cancer diagnoses are among those who will most benefit from accessing these life-saving services.
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