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Cancer diagnosis may encourage smoking cessation
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The receipt of a cancer diagnosis was associated with sustained smoking cessation regardless of the cancer’s prognosis or relation to smoking, according to study results.
“This is the first study to our knowledge to show that a cancer diagnosis, even for cancers not strongly related to smoking, can lead to higher quit rates,” J. Lee Westmaas, PhD, of the Behavioral Research Center at the American Cancer Society, said in a press release. “It appears a cancer diagnosis acts as a sort of ‘cue-to-action’ that leads smokers to quit.”
Whether a cancer diagnosis prompted smoking cessation, particularly for patients whose cancers are not directly linked to smoking, was previously unclear, according to study background. Prior estimates have indicated the smoking prevalence among cancer survivors ranges from 15% to 33%.
Westmaas and colleagues evaluated data from participants enrolled in the Cancer Prevention Study-II Nutrition Cohort. Participants reported smoking status at the time of enrollment in 1992 through 1993 and approximately every 2 years until 2009. Researchers evaluated smoking cessation rates at 2- and 4-year intervals for smokers who had or had not received a cancer diagnosis.
Researchers stratified quit rates by age, sex, survey year, cardiovascular disease and chronic obstructive pulmonary disease diagnosis. Patients diagnosed with cancers strongly linked to smoking or cancers likely to cause physical limitations — including lung cancer, oropharyngeal cancer, esophageal cancer and any metastatic cancer — were excluded from the analysis. The most frequently diagnosed cancers in the cohort were prostate (30.7%), breast (25.1%), bladder (11.5%) and colorectal cancers (11.4%).
Overall, the 2-year quit rate was significantly higher among smokers who received a cancer diagnosis (31.3%; 95% CI, 28-34.5) compared with smokers who did not receive a cancer diagnosis (19.5%; 95% CI, 19-19.9).
Quit rates were significantly associated with sex (P = .02) and health status (P = .04). Both female and male smokers diagnosed with cancer displayed higher quit rates than smokers without cancer, although the difference was greater among women (33.6% vs. 17.7%) than men (28.8% vs. 21%).
Quit rates among smokers diagnosed with a chronic smoking-related disease such as chronic obstructive pulmonary disease or cardiovascular disease were similar whether or not the participants received a diagnosis of cancer (22.3% vs. 19.1%). However, quit rates were much higher in patients diagnosed with cancer who did not have a chronic smoking-related disease (33.3% vs. 19.6%).
Cancer type or stage at diagnosis were not significantly associated with smoking cessation.
The adjusted quit rates at the 4-year interval were 43% among smokers diagnosed with cancer and 33.8% among smokers not diagnosed with cancer (P < .001). Smoking relapse at the 4-year interval was similar among smokers who had and had not been diagnosed with cancer (12.4% vs. 15.4%).
“Our study shows doctors can capitalize on this potentially teachable moment by discussing options for cessation treatment, by affirming the benefits of quitting, and by providing resources for follow-up tracking and support, even for non-smoking–related cancers,” Westmaas said. – by Cameron Kelsall
Disclosure: Westmaas reports no relevant financial disclosures. One researcher reports stock ownership in Johnson & Johnson and Procter & Gamble.
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