Taking a Closer Look at Smoking and Smoking Cessation Among Cancer Survivors

Cigarette smoking is causally linked to many cancers. A new study looks at smoking and the use of cessation aids among survivors of tobacco-associated cancers (TAC) and non-tobacco-associated cancers (nTAC) using Kentucky Cancer Registry data, specifically lung, colorectal, pancreatic, female breast, ovarian, and prostate cancer cases. From 2007 to 2011, there were 10,033 TAC survivors and 13,670 nTAC survivors identified from the Kentucky Cancer Registry. Study results showed that a history of smoking in the 12 months before a cancer diagnosis was higher for TAC survivors (64%) than for nTAC survivors (40%). Smoking cessation counseling before and/or after a cancer diagnosis was significantly more common among TAC survivors (4.8%) compared to nTAC survivors (2.2%). Recommending tobacco cessation counseling services and medications or including these resources in survivorship care plans are actions that health care providers can take to help cancer survivors improve their quality of life and reduce the risk of further disease.

2019 Feb 14. doi: 10.1007/s10900-019-00622-z. [Epub ahead of print]

Smoking and Smoking Cessation Among Persons with Tobacco- and Non-tobacco-Associated Cancers.

Gallaway MS1, Huang B2,3, Chen Q3, Tucker TC3,4, McDowell JK3, Durbin E3,5, Stewart SL6, Tai E6.

Author information

Abstract

PURPOSE:

To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors.

METHODS:

Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007-2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. TACs included colorectal, pancreatic, and lung cancers; nTAC included breast, ovarian, and prostate cancers.

RESULTS:

There were 10,033 TAC and 13,670 nTAC survivors. Smoking before diagnosis was significantly higher among TAC survivors (p < 0.0001). Among TAC survivors, smoking before diagnosis was significantly higher among persons who: were males (83%), aged 45-64 (83%), of unknown marital status (84%), had very low education (78%), had public insurance (89%), Medicaid (85%) or were uninsured (84%). Smoking cessation counseling and pharmacotherapy were more common among TAC than nTAC survivors (p < 0.01 and p = 0.05, respectively).

DISCUSSION:

While smoking cessation counseling and pharmacotherapy were higher among TAC survivors, reducing smoking among all cancer survivors remains a priority, given cancer survivors are at increased risk for subsequent chronic diseases, including cancer. Tobacco cessation among all cancer survivors (not just those with TAC) can help improve prognosis, quality of life and reduce the risk of further disease. Health care providers can recommend for individual, group and telephone counseling and/or pharmacotherapy recommendations. These could also be included in survivorship care plans.