The State of the Science on Cancer Diagnosis as a “Teachable Moment” for Smoking Cessation: A Scoping Review

Abstract

Theoretically, cancer diagnosis has potential to spur health behavior changes in physical activity, diet, substance use, medication adherence and the like. The Teachable Moment heuristic is a parsimonious, transtheoretical framework for understanding the conditions under which behavior change might occur, with constructs that include affective, cognitive, and social factors. Application of the Teachable Moment to smoking cessation after cancer diagnosis might aid selection of predictors in observational studies and inform how to optimally design interventions to promote quit attempts and sustain abstinence, as many smoking cessation interventions for cancer survivors do not yield positive outcomes. This scoping review of 47 studies that span nearly 20 years of literature examines measurement of the Teachable Moment constructs and what empirical support they have in explaining cancer survivors’ smoking behavior. From this review, it appears the construct of affective response is more widely explored than risk perceptions, social role, and self-concept. Strong, negative affective responses (e.g., anxiety, general distress) may be a powerful contributor to continued smoking after cancer diagnosis. Risk perceptions may also play a role in smoking behavior, such that never and former smokers espouse stronger perceptions of smoking-related risks than current smokers. Finally, due to a paucity of studies, the role of cancer survivors’ self-concept (e.g., identity as a “cancer survivor”) and changes in their social role (e.g., employee, athlete) are unclear contributors to their smoking behavior. In summary, the Teachable Moment holds promise in its application to smoking cessation after cancer diagnosis, though more direct research is needed.

Challenges and Needs of HPV-Positive Women

“…WHO says cervical cancer is largely preventable, 21 as noted in previous studies, cancer screening can serve as a valuable opportunity to promote a healthy lifestyle. 22 , 23 …”

“…WHO says cervical cancer is largely preventable, 21 as noted in previous studies, cancer screening can serve as a valuable opportunity to promote a healthy lifestyle. 22,23 One of the needs of infected women is to obtain information on the effects of pregnancy on the HPV virus. Lack of sufficient information in this regard and fear of exacerbation or misdiagnosis of the disease has led to a low desire to conceive, and HPV-infected women are advised what to do for a healthy pregnancy or how to manage it.…”

The Longitudinal Impact of Arrest, Criminal Conviction, and Incarceration on Smoking Classes

“…Secondly, an alternative notion is that going through the justice system can provide a “teachable moment”, 17 , 18 , 19 , 20 bringing about positive change for an individual, such as decreasing their smoking levels. Prior research has found support for the impact of surgery, 21 a cancer diagnosis, 22 hospital treatment for illness 23 and HIV treatment 24 as “teachable moments” to reduce individuals’ smoking.…”

A telephone-based smoking cessation intervention for individuals with COVID-19: A randomized controlled feasibility study

“…Increasing evidence suggests that a diagnosis of a respiratory health condition can encourage and induce smoking cessation. Pulmonary tuberculosis diagnosis 8 , lung cancer screening and diagnosis 9,10 , and even a diagnosis of an acute or chronic respiratory disease (such as influenza and chronic obstructive pulmonary disease, respectively) 11 , amongst others, have been found to prompt smoking cessation. This is because such health-related events are often seen as 'teachable moments', i.e.…”