Correlates of smoking status in cancer survivors

Abstract

Purpose: To determine the characteristics associated with cancer survivors which indicate continued cigarette smoking at or around the time of cancer diagnosis. Methods: 631 survivors were recruited in four cancer centers in Memphis, TN, between March 2015 and June 2016. To increase the probability of accurate reporting, surveys were conducted anonymously. 112 respondents reported they were current smokers and 202 reported they were former smokers (n=314), who comprised the sample. Results: We found that the rate of daily e-cigarette use among cancer survivors who smoked was 15.2% versus 3.9% in cancer survivors who no longer smoked. (The national rate of adult e-cigarette use is 3.5%.) Multivariate models correlated the characteristics of current versus former smokers and revealed that increasing age (aOR=0.97, p<.0001), decreasing education (aOR=2.39, p<.02) and current use of e-cigarettes (aOR=3.74, p<.00045) were frequently associated with current cigarette smoking. Conclusions: While age and gender were associated with continued smoking, current use of e-cigarettes was associated with almost four times higher odds of being a current smoker. Further research is needed to determine if use of e-cigarettes deters or promotes the smoking cessation process, at least in cancer survivors. Implications for Cancer Survivors: Among cancer survivors who continue to smoke after a cancer diagnosis, use of e-cigarettes is highly prevalent; research is needed to determine whether use of e-cigarettes promotes, has no effect, or hinders smoking cessation efforts among this vulnerable population.

Tobacco Use and Tobacco Treatment Referral Response of Patients With Cancer: Implementation Outcomes at a National Cancer Institute–Designated Cancer Center

“…Therefore, the last two columns provide results from a partial proportional odds model where the proportional odds assumptions held for race and ethnicity and relationship status, but not for clinic, sex, insurance status, age tertiles, and distress tertiles. tobacco treatment, study results point toward a focus on patients with cancer who are male, are not in a relationship, have Medicaid insurance, and report high distress, consistent with previous studies on correlates of smoking in patients with cancer 7,46,47 ; the results for disease site or clinic were mixed, so firm conclusions are untenable.…”

“… 17 , 31 There might even be sufficient reason to extend core items of the Cancer Patient Tobacco Use Questionnaire to include questions about noncigarette tobacco use 13 , 17 and to extend eligibility for clinical trials and treatment programs to all patients with cancer who use tobacco, not just those who smoke cigarettes. 43 - 45 In trying to reach the target audience for tobacco treatment, study results point toward a focus on patients with cancer who are male, are not in a relationship, have Medicaid insurance, and report high distress, consistent with previous studies on correlates of smoking in patients with cancer 7 , 46 , 47 ; the results for disease site or clinic were mixed, so firm conclusions are untenable.…”

E-Cigarette Use and Adult Cigarette Smoking Cessation: A Meta-Analysis

“…Choi and Forster 79 Biener and Hargraves 23 ; daily EC use Giovenco and Delnevo 13 ; prior but no current EC use Kalkhoran et al 49 ; less than daily EC use Little et al 54 Subtotal (I 2 = 76.3%; P < .001) Subtotal (I 2 = 97.5%; P < .001)…”

A descriptive study of cervical cancer survivors’ persistent smoking behavior and perceived barriers to quitting.

“…This study did not ascertain the reason for noncigarette tobacco use, but one could surmise that it is due to the belief these products might aid smoking cessation or be a helpful substitute in places or during times when smoking is prohibited (Popova & Ling, 2013; Shi et al, 2017). Reports of electronic cigarette use in cancer survivors have grown in recent years (Akinboro et al, 2019; Kalkhoran et al, 2018), though research on other products remains rare (see Little et al, 2018 for an exception). Importantly, trial and adoption of electronic cigarettes and the like among cancer survivors who smoke may outpace the rate at which we accumulate empirical evidence of their safety profile and effectiveness for smoking cessation (Kalkhoran & Glantz, 2016; McRobbie et al, 2014).…”

“…It is possible that correlates for CCS’ smoking behavior are largely consistent with what is found in other cancer survivor samples. If that literature is applied to CCS, younger age, lower socioeconomic status, lower levels of education, White race, and less healthcare access would be risk factors; stronger cancer-related risk perceptions, motivation to quit, and self-efficacy to quit would be protective factors; and gender, ethnicity, cancer stage, cancer treatment, time since cancer diagnosis, and emotional problems would show weak or inconsistent relationships (Little et al, 2018; Mayer & Carlson, 2011; Swoboda et al, 2019; Tseng et al, 2010; Waggoner et al, 2010).…”