Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers
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Despite the well-established risks associated with persistent smoking, many cancer survivors who were active smokers at the time of cancer diagnosis continue to smoke. In order to guide the development of tobacco cessation interventions for cancer survivors, a better understanding is needed regarding post-diagnosis quitting efforts. Thus, we examined quitting and reduction efforts and interest in cessation resources among cancer survivors who self-identified as current smokers at the time of diagnosis.
We conducted analyses of survey participants (n = 54) who were current smokers at the time of cancer diagnosis and were continued smokers at the time of assessment. We also conducted semi-structured interviews (n = 21) among a subset of those who either continued to smoke or quit smoking post-cancer diagnosis.
Among our survey participants, 22.2 % had ever used behavioral cessation resources and 66.7 % had use pharmacotherapy, while 62.8 % had interest in future use of behavioral cessation resources and 75.0 % had interest in pharmacotherapy. The majority reported some quitting efforts including making quit attempts, using cessation medications, and reducing their daily cigarette consumption. Semi-structured interview data revealed various strategies used to aid in smoking reduction and cessation as well as variability in preferences for cessation resources.
Cancer patients who smoke following diagnosis often engage in smoking reduction and cessation-related behaviors, which may reflect their motivation to reduce their smoking-related risks. They also report high interest in cessation resources. Thus, it is important to explore the acceptability and effectiveness of different cessation intervention components among this group.
Implications for Cancer Survivors
Cancer survivors who smoke demonstrate actions toward harm reduction and cessation. They should inquire about potential resources that might facilitate their efforts among their healthcare providers and enlist support and advice from others around them to bolster their efforts.
- American Cancer Society. Cancer Facts and Figures, 2011. http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2011. Accessed 10 July 2012.
- Travis, LB, Rabkin, CS, Brown, LM, Allan, JM, Alter, BP, Ambrosone, CB (2006) Cancer survivorship—genetic susceptibility and second primary cancers: research strategies and recommendations. J Natl Cancer Inst 98: pp. 15-25 CrossRef
- Surveillance of Demographic Characteristics and Health Behaviors Among Adult Cancer Survivors—Behavioral Risk Factor Surveillance System, United States, 2009. MMWR Morb Mortal Wkly Rep 61: pp. 1-23
- Cooley, ME, Lundin, R, Murray, L (2009) Smoking cessation interventions in cancer care: opportunities for oncology nurses and nurse scientists. Annu Rev Nurs Res 27: pp. 243-272 CrossRef
- Underwood JM, Townsend JS, Tai E, White A, Davis SP, Fairley TL. Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis. J Cancer Surviv. 2012; doi: 10.1007/s11764-012-0230-1
- Rochers, C, Dische, S, Saunders, MI (1992) The problem of cigarette smoking in radiotherapy for cancer in the head and neck. Clin Oncol (R Coll Radiol) 4: pp. 214-216 CrossRef
- Parsons, A, Daley, A, Begh, R, Aveyard, P (2010) Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 340: pp. b5569 CrossRef
- Browman, GP, Wong, G, Hodson, I, Sathya, J, Russell, R, McAlpine, L (1993) Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Engl J Med 328: pp. 159-163 CrossRef
- Stevens, MH, Gardner, JW, Parkin, JL, Johnson, LP (1983) Head and neck cancer survival and life-style change. Arch Otolaryngol 109: pp. 746-749 CrossRef
- Johnston-Early, A, Cohen, MH, Minna, JD, Paxton, LM, Fossieck, BE, Ihde, DC (1980) Smoking abstinence and small cell lung cancer survival. An association. JAMA J Am Med Assoc 244: pp. 2175-2179 CrossRef
- Mason, DP, Subramanian, S, Nowicki, ER, Grab, JD, Murthy, SC, Rice, TW (2009) Impact of smoking cessation before resection of lung cancer: a Society of Thoracic Surgeons General Thoracic Surgery Database Study. Ann Thorac Surg 88: pp. 362-371 CrossRef
- Chelghoum, Y, Danaïla, C, Belhabri, A, Charrin, C, Le, QH, Michallet, M (2002) Influence of cigarette smoking on the presentation and course of acute myeloid leukemia. Ann Oncol 13: pp. 1621-1627 CrossRef
- Karim, AB, Snow, GB, Siek, HT, Njo, KH (1983) The quality of voice in patients irradiated for laryngeal carcinoma. Cancer 51: pp. 47-49 CrossRef
- Rugg, T, Saunders, MI, Dische, S (1990) Smoking and mucosal reactions to radiotherapy. Br J Radiol 63: pp. 554-556 CrossRef
- Tyc, VL, Hudson, MM, Hinds, P, Elliott, V, Kibby, MY (1997) Tobacco use among pediatric cancer patients: recommendations for developing clinical smoking interventions. J Clin Oncol 15: pp. 2194-2204
- Gritz, ER, Kristeller, J, Burns, DM Treating nicotine addiction in high-risk groups and patients with medical co-morbidity. In: Orleans, CT, Slade, J eds. (1993) Nicotine addiction: principles and management. Oxford University Press, New York, pp. 279-309
- US Department of Health and Human Services. The Health Consequences of Smoking: Cardiovascular Disease: A Report of the Surgeon General, 1983. http://profiles.nlm.nih.gov/NN/B/B/T/D/ Accessed 10 July 2012.
- US Department of Health and Human Services. The Health Benefits of Smoking Cessation. A Report of the Surgeon General. http://profiles.nlm.nih.gov/NN/B/B/C/T/. Accessed 10 July 2012.
- Wynder, EL, Mushinski, MH, Spivak, JC (1977) Tobacco and alcohol consumption in relation to the development of multiple primary cancers. Cancer 40: pp. 1872-1878 CrossRef
- Day, GL, Blot, WJ, Shore, RE, McLaughlin, JK, Austin, DF, Greenberg, RS (1994) Second cancers following oral and pharyngeal cancers: role of tobacco and alcohol. J Natl Cancer Inst 86: pp. 131-137 CrossRef
- Do, KA, Johnson, MM, Doherty, DA, Lee, JJ, Wu, XF, Dong, Q (2003) Second primary tumors in patients with upper aerodigestive tract cancers: joint effects of smoking and alcohol (United States). Cancer Causes Contr 14: pp. 131-138 CrossRef
- Blum, A Cancer prevention: preventing tobacco-related cancers. In: DeVita, VT, Hellman, S, Rosenberg, SA eds. (1997) Cancer: principles and practice of oncology. Lippincott-Raven Publishers, Philadelphia, pp. 545-557
- Khuri, FR, Lee, JJ, Lippman, SM, Kim, ES, Cooper, JS, Benner, SE (2006) Randomized phase III trial of low-dose isotretinoin for prevention of second primary tumors in stage I and II head and neck cancer patients. J Natl Cancer Inst 98: pp. 441-450 CrossRef
- Cox, LS, Africano, NL, Tercyak, KP, Taylor, KL (2003) Nicotine dependence treatment for patients with cancer. Cancer 98: pp. 632-644 CrossRef
- Richardson, GE, Tucker, MA, Venzon, DJ, Linnoila, RI, Phelps, R, Phares, JC (1993) Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers. Ann Intern Med 119: pp. 383-390
- Tucker, MA, Murray, N, Shaw, EG, Ettinger, DS, Mabry, M, Huber, MH (1997) Second primary cancers related to smoking and treatment of small-cell lung cancer. Lung Cancer Working Cadre. J Natl Cancer Inst 89: pp. 1782-1788 CrossRef
- Johnson, BE (1998) Second lung cancers in patients after treatment for an initial lung cancer. J Natl Cancer Inst 90: pp. 1335-1345 CrossRef
- Kawahara, M, Ushijima, S, Kamimori, T, Kodama, N, Ogawara, M, Matsui, K (1998) Second primary tumours in more than 2-year disease-free survivors of small-cell lung cancer in Japan: the role of smoking cessation. Br J Cancer 78: pp. 409-412 CrossRef
- Tobacco cessation and quality cancer care. J Oncol Pract 5: pp. 2-5 CrossRef
- Gritz, ER, Carr, CR, Rapkin, DA, Chang, C, Beumer, J, Ward, PH (1991) A smoking cessation intervention for head and neck cancer patients: trial design, patient accrual, and characteristics. Cancer Epidemiol Biomarkers Prev 1: pp. 67-73
- Gritz, ER, Fingeret, MC, Vidrine, DJ, Lazev, AB, Mehta, NV, Reece, GP (2006) Successes and failures of the teachable moment: smoking cessation in cancer patients. Cancer 106: pp. 17-27 CrossRef
- Stanislaw, AE, Wewers, ME (1994) A smoking cessation intervention with hospitalized surgical cancer patients: a pilot study. Cancer Nurs 17: pp. 81-86 CrossRef
- Griebel, B, Wewers, ME, Baker, CA (1998) The effectiveness of a nurse-managed minimal smoking-cessation intervention among hospitalized patients with cancer. Oncol Nurs Forum 25: pp. 897-902
- Wewers, ME, Bowen, JM, Stanislaw, AE, Desimone, VB (1994) A nurse-delivered smoking cessation intervention among hospitalized postoperative patients—influence of a smoking-related diagnosis: a pilot study. Heart Lung 23: pp. 151-156
- Schnoll, RA, James, C, Malstrom, M, Rothman, RL, Wang, H, Babb, J (2003) Longitudinal predictors of continued tobacco use among patients diagnosed with cancer. Ann Behav Med 25: pp. 214-222 CrossRef
- Shields, PG (2002) Tobacco smoking, harm reduction, and biomarkers. J Natl Cancer Inst 94: pp. 1435-1444 CrossRef
- Godtfredsen, N, Prescott, E, Osler, M (2005) Effect of smoking reduction on lung cancer risk. JAMA J Am Med Assoc 294: pp. 1505-1510 CrossRef
- Institute of Medicine. Clearing the smoke: assessing the science base for tobacco harm reduction. Institute of Medicine, Committee to Assess the Science Base for Tobacco Harm Reduction, Board on Health Promotion and Disease Prevention: Washington, DC; 2001.
- Hughes, JR, Carpenter, MJ (2006) Does smoking reduction increase future cessation and decrease disease risk? A qualitative review. Nicotine Tob Res 8: pp. 739-749 CrossRef
- Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Survey Data (BRFSS). 2008.
- Results from the 2008 National Survey on Drug Use and Health: National Findings, 2009. Office of Applied Studies, Rockvillle
- Heatherton, TF, Kozlowski, LT, Frecker, RC, Fagerström, KO (1991) The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict 86: pp. 1119-1127 CrossRef
- Biener, L, Abrams, DB (1991) The contemplation ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol 10: pp. 360-365 CrossRef
- Maibach, EW, Maxfield, A, Ladin, K, Slater, M (1996) Translating health psychology into effective health communication. J Health Psychol 1: pp. 261-267 CrossRef
- Tobacco Control Section, California Tobacco Survey: 1999. Cancer Prevention and Control Unit, Jolla
- Prochaska JO, DiClemente CC. Self change processes, self-efficacy and decisional balance across five stages of smoking cessation. Advances in Cancer Control—1983–1984. New York: Alan R. Liss; pp. 131–140.
- Berg CJ, Thomas AN, Mertens AC, Schauer GL, Pinsker EA, Ahluwalia JS, et al. Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Psychooncology. 2012; doi: 10.1002/pon.3077
- Morgan, DL, Krueger, RA (1998) The Focus Group Kit. Sage, Thousand Oaks
- Patton, M (2002) Qualitative Research and Evaluation Methods. Sage, Thousand Oaks
- Miles, MB, Huberman, AM (1994) Qualitative data analysis: an expanded sourcebook. Sage, Thousand Oaks
- Tobacco use among adults—United States 2005. MMWR Morb Mortal Wkly Rep 55: pp. 1145-1148
- Shiffman, S, Brockwell, SE, Pillitteri, JL, Gitchell, JG (2008) Use of smoking-cessation treatments in the United States. Am J Prev Med. 34: pp. 102-111 CrossRef
- Shiffman, S, Brockwell, SE, Pillitteri, JL, Gitchell, JG (2008) Individual differences in adoption of treatment for smoking cessation: demographic and smoking history characteristics. Drug Alcohol Depend 93: pp. 121-131 CrossRef
- Davis, R, Rizwani, W, Banerjee, S, Kovacs, M, Haura, E, Coppola, D (2009) Nicotine promotes tumor growth and metastasis in mouse models of lung cancer. PLoS One 4: pp. e7524 CrossRef
- National Cancer Institute. Risks Associated With Smoking Cigarettes With Low Machine-Measured Yields of Tar and Nicotine. Smoking and Tobacco Control Monograph 13. Bethesda: National Cancer Institute; 2001.
- US Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General 2004. http://www.surgeongeneral.gov/library/reports/smokingconsequences/index.html . Accessed 10 July 2012.
- Augustine, A, Harris, RE, Wynder, EL (1989) Compensation as a risk factor for lung cancer in smokers who switch from nonfilter to filter cigarettes. Am J Public Health 79: pp. 188-191 CrossRef
- Stellman, SD, Muscat, JE, Hoffmann, D, Wynder, EL (1997) Impact of filter cigarette smoking on lung cancer histology. Prev Med. 26: pp. 451-456 CrossRef
- Hoffmann, D, Hoffmann, I (1997) The changing cigarette, 1950–1995. J Toxicol Environ Health. 50: pp. 307-364 CrossRef
- National Cancer Institute, Risks associated with smoking cigarettes with low machine-measured yields of tar and nicotine, in Smoking and tobacco control [Monograph 13]2002: Washington, DC.
- Wennike, P, Danielsson, T, Landfeldt, B, Westin, A, Tønnesen, P (2003) Smoking reduction promotes smoking cessation: results from a double blind, randomized, placebo-controlled trial of nicotine gum with 2-year follow-up. Addiction 98: pp. 1395-1402 CrossRef
- Asfar, T, Ebbert, JO, Klesges, RC, Relyea, GE (2011) Do smoking reduction interventions promote cessation in smokers not ready to quit?. Addict Behav 36: pp. 764-768 CrossRef
- Harm reduction and cessation efforts and interest in cessation resources among survivors of smoking-related cancers
Journal of Cancer Survivorship
Volume 7, Issue 1 , pp 44-54
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- Author Affiliations
- 1. Department of Behavioral Sciences and Health Education, Emory University School of Public Health, 1518 Clifton Road, NE, Room 524, Atlanta, GA, 30322, USA
- 2. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- 3. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
- 4. Behavioral Sciences Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA