Smoking, vaping linked to higher symptom burden among cancer survivors
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Key takeaways:
- Current smoking appeared associated with greater fatigue, pain and emotional problems, as well as worse quality of life.
- Symptom burden had no relationship with survivors’ desire or plans to quit smoking.
Current smoking and vaping appeared associated with higher symptom burden among adult cancer survivors, according to data published in Cancer.
Conversely, cancer survivors’ interest in or intentions to quit smoking had no association with symptoms burden, researchers wrote.
“Our team hypothesized that individuals with a cancer history who were smoking and/or vaping after diagnosis would report greater symptom burden (greater severity of fatigue, pain, emotional problems) and worse quality of life, which was supported by our findings,” Sarah N. Price, PhD, postdoctoral fellow in the cancer prevention and control training program at Wake Forest University School of Medicine, told Healio. “What was more surprising was that the extent to which survivors reported elevated fatigue, pain, or emotional problems or worse quality of life was not related to their desire to quit or plans to quit.”
Background and methodology
Cigarette smoking is both a major modifiable risk factor for cancer and a top cause of preventable cancer mortality. Those who continue to smoke following a cancer diagnosis have lower survival rates and higher likelihood of recurrence and second malignancies, according to researchers. Smoking also has been associated with reduced efficacy of cancer-directed therapy.
Identifying a potential relationship between tobacco use and symptom burden may better inform tobacco treatment interventions tailored to the needs of individuals with cancer, researchers wrote.
The investigators analyzed 1,409 adult cancer survivors from Wave 5 of the U.S. FDA Population Assessment of Tobacco and Health (PATH) Study. They evaluated the potential association of both cigarette smoking and vaping on cancer-related symptom burden (fatigue, pain, emotional problems) and quality of life using a multivariable analysis of variance that controlled for age, sex and race/ethnicity.
Researchers calculated weighted rates of 14.21% among the study population for cigarette smoking and 2.88% for vaping.
Results
Researchers found associations of current smoking with greater fatigue (P < .0001; partial eta2 = .02), pain (P < .0001; partial eta2 = .08), emotional problems (P < .0001; partial eta2 = .02), and worse quality of life (P < .0001; partial eta2 = .08), whereas current vaping appeared associated with greater fatigue (P = .001; partial eta2 = .008), pain (P = .009; partial eta2 = .005) and emotional problems (P = .04; partial eta2 = .003), but not worse quality of life.
Reduced interest in quitting, likelihood of quitting or odds of past year quit attempts did not appear associated with higher cancer symptom burden.
Next steps
It is critically important for oncology providers to assess tobacco use, offer tobacco-cessation support and take ownership of the delivery of tobacco treatment to patients with cancer, according to researchers.
“We hope that findings from this study and others like it might assist oncology clinicians in talking to their patients about smoking,” Price told Healio. “Knowing that reducing smoking could potentially provide symptom relief and improve their quality of life may be especially compelling to cancer survivors who are considering changing their smoking habits.
“More research (especially longitudinal and interventional work) is needed to strengthen the claim that reducing or quitting smoking directly improves cancer-related symptoms,” she added. “Additionally, future research should explore whether framing smoking cessation as part of cancer symptom management makes it more acceptable to both patients and treating clinicians and whether better management of cancer symptoms helps survivors quit smoking.”
For more information:
Sarah N. Price, PhD, can be reached at Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC 27101; email: sarahpr@wakehealth.edu.
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