Characterizing risky alcohol use, cigarette smoking, e-cigarette use, and physical inactivity among cancer survivors in the USA—a cross-sectional study

Abstract

Purpose Unhealthy lifestyle behaviors are associated with inferior health outcomes among cancer survivors, including increased mortality. It is crucial to identify vulnerable subgroups, yet investigations have been limited. Thus, this study aimed to examine sociodemographic and clinical characteristics associated with risky health behaviors among cancer survivors. Methods We used national, cross-sectional survey data (Health Information National Trends Survey, HINTS 2017–2020) for 2579 cancer survivors. We calculated the prevalence of risky alcohol use, current cigarette smoking, e-cigarette use, and not meeting physical activity guidelines. We performed weighted logistic regression to obtain multivariable-adjusted odds ratios (OR) for the association between each unhealthy behavior with sociodemographic and clinical characteristics. Results Overall, 25% showed risky alcohol use, 12% were current cigarette smokers, 3% were current e-cigarette users, and 68% did not meet physical activity guidelines. Cancer survivors who were males, non-Hispanic Whites or African Americans, without a college education, not married and with comorbidities or psychological distress were more likely to have unhealthy behaviors. Those with lung disease or depression were 2 times as likely to smoke cigarette or e-cigarettes and those with psychological distress were 1.6 times as likely to be physically inactive. Moreover, risky drinkers (OR = 1.75, 95% CI = 1.22–2.52) and e-cigarette smokers (OR = 16.40, 95% CI 3.29–81.89) were more likely to be current cigarette smokers. Conclusions We identified vulnerable subpopulations of cancer survivors with multiple unhealthy lifestyle behaviors. Implications for Cancer Survivors Our findings inform clinicians and program and policy makers of the subgroups of cancer survivors to target for multiple health behavior interventions.

Association between adverse childhood experiences and self-reported health-risk behaviors among cancer survivors: A population-based study

“…In our study, we noticed younger cancer survivors have comparatively more inclination toward health-risk behaviors than their older counterparts. Our study findings are consistent with extant literature in the field of oncology [51][52][53][54][55]. For example, a recent study [56], used nationally representative data to compare cigarette smoking prevalence among cancer survivors with smoking-related cancers with cancer survivors with non-smoking-related cancers.…”

“…A research study that investigated the smoking prevalence trend between the years 1997 to 2010 among adults (with or without childhood cancer history) found a similar association between education and smoking behavior [ 51 ]. Similarly, another cross-sectional study with cancer survivors noticed higher odds of current cigarette and e-cigarette use among comparatively less educated individuals (high school graduate & some college) than the individuals who hold graduate degree or more academic qualifications [ 52 ]. Some possible explanations may be that people with higher education often have more employment and financial security—both of which serve to mitigate stresses associated with socioeconomic status and access to resources [ 57 ].…”

Sociodemographic and Health Correlates of Multiple Health Behavior Adherence among Cancer Survivors: A Latent Class Analysis

“…Recent research suggests that sociodemographic, cancer-, and health-related factors are associated with adherence to both single- and multiple health behavior recommendations among cancer survivors [ 22 , 23 ]. Cancer survivors who were biologically male, non-Hispanic White or Black, with a high school education or less, not married, and diagnosed with comorbidities were more likely to consume alcohol, smoke cigarettes or e-cigarettes, and have a physically inactive lifestyle [ 22 ].…”

“…Recent research suggests that sociodemographic, cancer-, and health-related factors are associated with adherence to both single- and multiple health behavior recommendations among cancer survivors [ 22 , 23 ]. Cancer survivors who were biologically male, non-Hispanic White or Black, with a high school education or less, not married, and diagnosed with comorbidities were more likely to consume alcohol, smoke cigarettes or e-cigarettes, and have a physically inactive lifestyle [ 22 ]. Similarly, racial and ethnic differences have been characterized for alcohol consumption (e.g., non-Hispanic Whites more commonly reported) and higher BMI (e.g., Black individuals more commonly reported) among breast cancer survivors [ 24 ].…”