Original Article

Supportive Care in Cancer

, Volume 22, Issue 12, pp 3125-3134

First online:

Smoking status, service use and associated factors among Japanese cancer survivors—a web-based survey

  • Daisuke FujisawaAffiliated withPsycho-Oncology Division, National Cancer Center EastCenter for Psychiatric Oncology and Behavioral Sciences, Massachusetts General HospitalDepartment of Neuropsychiatry, Keio University School of Medicine Email author 
  • , Shino UmezawaAffiliated withPsycho-Oncology Division, National Cancer Center EastSection of Liaison Psychiatry and Palliative Medicine Division of Comprehensive Patient Care, Tokyo Medical and Dental University
  • , Ado Basaki-TangeAffiliated withPsycho-Oncology Division, National Cancer Center East
  • , Maiko FujimoriAffiliated withPsycho-Oncology Division, National Cancer Center EastNational Center for Neurology and Psychiatry
  • , Mitsunori MiyashitaAffiliated withDivision of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine

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This study aims to investigate smoking status and its associated factors among Japanese cancer survivors. We stretched our focus on association with health-related behaviors other than smoking (alcohol intake, physical exercise, and social activity) and the smoking cessation strategies used by cancer survivors.


An anonymous cross-sectional web-based survey was conducted, enrolling survivors of various types of cancer up to 10 years after diagnosis. Smoking status, socioeconomic status, health-related behaviors other than smoking, and smoking cessation resource that the participants used were evaluated. Factors associated with continuous smoking after cancer diagnosis were explored using multivariate analysis.


Among 168 participants who were smoking at the time of cancer diagnosis, 96 participants (57.1 %) continued smoking. Sixty-seven survivors (69.8 %) were willing to reduce or quit smoking, however, only 39 survivors (40.6 %) were provided with counseling or intervention on smoking cessation. Male gender, shorter time after cancer diagnosis, and lack of regular physical exercise associated with continuous smoking. Higher level of fear of cancer recurrence had trend-level significance of association with smoking cessation.


Substantial proportions of Japanese cancer survivors continue smoking after diagnosis of cancer. The majority of them are not provided with relevant information or support, despite their willingness of reducing or quitting smoking. Smoking cessation is associated with other health behaviors (i.e., physical exercise). This suggests considerable missed opportunities for health-care providers to provide cancer survivors with counseling and evidence-based interventions. Promotion of professional support on smoking cessation and education to encourage healthy behaviors are needed.


Cancer survivor Smoking cessation Risk factor Health behavior Exercise