Risk factors for smoking among adolescent survivors of childhood cancer: A report from the childhood cancer survivor study

Abstract

Background Few studies have examined risk factors for smoking among adolescent survivors of childhood cancer. The present study reports on the rate of smoking and identifies factors associated with smoking in a sample of adolescent survivors from the Childhood Cancer Survivor Study (CCSS). Procedure Participants included 307 adolescent survivors and 97 healthy siblings (ages 14-20) who completed a self-report survey of health, quality of life, and health behaviors. Results Smoking rates did not differ significantly between survivor and sibling groups (Ever Smokers: 28% vs. 33%, Recent Smokers: 10% vs. 9%, respectively). Ever smoking was significantly associated with peer smoking, smokers in the household, binging, suicidal behavior, and no history of CRT. There were significant interactions of peer smoking with gender and CRT for ever smoking and with binging for recent smoking. Recent smoking was more likely for survivors with other household smokers (RR=2.24, CI=1.21-4.16), past suicidality (RR=1.89, CI=1.00-3.56), and no CRT (RR=2.40, CI=1.12-5.17). Among survivors with few smoking friends, ever smoking was more likely for survivors with no CRT (RR=4.47, CI=1.43-13.9), and recent smoking was more likely among survivors who binged (RR=3.37, CI=1.17-9.71). Conclusions Despite the health risks associated with survivorship, nearly one in three adolescent survivors of childhood cancer has smoked. Exposure to other smokers, in particular, appears to increase the likelihood of smoking for some survivors. Providing smoking cessation programs targeted to family members, helping survivors choose nonsmoking friends, and teaching ways to resist smoking influences from peers may be important pathways for smoking prevention with adolescent survivors.

Cardiotoxicity and Cardioprotection in Childhood Cancer

“…Kahalley et al [32] also found no significant difference in smoking rates between childhood cancer survivors and healthy sibling controls. However, Kahalley et al did address the correlation between the increased incidence of smoking and health risk factors, such as peer smoking, household smoking and suicidal behavior.…”

Cancer in childhood, adolescence, and young adults: a population-based study of changes in risk of cancer death during four decades in Norway

“…Due to improved therapy, 80 % of the children diagnosed with cancer will become long-term survivors [33]. Long-term survivors of childhood cancers are at increased risk of late mortality compared with the general population mainly due to treatment-related secondary neoplasms, and cardiac, and pulmonary deaths [31,[34][35][36][37]. A Nordic study by Moller et al [6] reported a reduction in the overall late mortality among long-term childhood cancer survivors over time.…”

Facteurs comportementaux et professionnels et prévention des seconds cancers primitifs après un cancer dans l’enfance ou dans l’adolescence : état des connaissances

“…Quatre s'intéressent aux différents comportements à risque dont l'alcool et le cannabis chez les adolescents et jeunes adultes ayant eu un cancer [5][6][7][8]. Trois articles concernent exclusivement le tabagisme [9][10][11] ; 6 articles concernent l'alimentation et l'activité physique [12][13][14][15][16][17]. Un article concerne exclusivement l'exposition solaire chez les enfants, adolescents et jeunes adultes ayant eu un cancer [18].…”

“…Parmi les cinq études qui abordent la question du tabagisme chez les jeunes ayant eu un cancer [6,7,[9][10][11], trois d'entre elles sont exclusivement dédiées au tabagisme [9][10][11]. Le tabagisme varie de 10 à 29 % dans cette population, selon les études.…”

“…Deux études retrouvent une prévalence significativement plus faible de tabagisme chez les survivants d'un cancer dans l'enfance ou l'adolescence par rapport à la population indemne de cancer du même âge [6,7]. Kahalley et al ont étudié les facteurs de risque de tabagisme chez 307 adolescents suivis dans la cohorte de la Childhood Cancer Survivor Study (CCSS) [9]. Les taux de fumeurs (10 %) et d'adolescents ayant déjà fumé (28 %) étaient comparables à ceux de la population générale du même âge (9 % et 33 %, respectivement).…”