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Awareness of the Harms of Continued Smoking Among Cancer Survivors

  • Lawson Eng
  • Devon Alton
  • Yuyao Song
  • Jie Su
  • Qihuang Zhang
  • Jiahua Che
  • Delaram Farzanfar
  • Rahul Mohan
  • Olivia Krys
  • Katie Mattina
  • Christopher Harper
  • Sophia Liu
  • Tom Yoannidis
  • Robin Milne
  • Nazek Abdelmutti
  • M. Catherine Brown
  • Ashlee Vennettilli
  • Andrew J. Hope
  • Doris Howell
  • Jennifer M Jones
  • Peter Selby
  • William K Evans
  • Wei Xu
  • David Paul Goldstein
  • Meredith Elana GiulianiEmail author
  • Geoffrey LiuEmail author
Original Article

Abstract

Background

Smoking cessation is an integral part of cancer survivorship. To help improve survivorship education, clinicians need an understanding of patient awareness of the harms of continued smoking.

Methods

Cancer survivors from Princess Margaret Cancer Centre (Toronto, ON) were surveyed on their awareness of the harms of continued smoking on cancer-related outcomes. Multivariable logistic regression models assessed factors associated with awareness and whether awareness was associated with subsequent cessation among smokers at diagnosis.

Results

Among 1118 patients, 23% were current smokers pre-diagnosis and 54% subsequently quit; 25% had lung and 30% head and neck cancers. Many patients reported being unaware that continued smoking results in greater cancer surgical complications (53%), increased radiation side effects (62%), decreased quality of life during chemotherapy (51%), decreased chemotherapy or radiation efficacy (57%), increased risk of death (40%), and increased development of second primaries (38%). Being a current smoker was associated with greater lack of awareness of some of these smoking harms (aORs = 1.53–2.20, P < 0.001–0.02), as was exposure to any second-hand smoke (aORs = 1.45–1.53, P = 0.006–0.04) and being diagnosed with early stage cancer (aORs = 1.38–2.31, P < 0.001–0.06). Among current smokers, those with fewer pack-years, being treated for cure, or had a non-tobacco-related cancer were more likely unaware. Awareness that continued tobacco use worsen quality of life after chemotherapy was associated with subsequent cessation (aOR = 2.26, P = 0.006).

Conclusions

Many cancer survivors are unaware that continued smoking can negatively impact cancer-related outcomes. The impact of educating patients about the potential harms of continued smoking when discussing treatment plans should be further evaluated.

Keywords

Smoking cessation Patient education Cancer survivorship Patient awareness 

Notes

Funding Information

This research was supported in part by the Alan B Brown Chair in Molecular Genomics, the CCO Chair in Experimental Therapeutics and Population studies, and the Posluns Family Foundation.

Compliance with Ethical Standards

The institutional (University Health Network) research ethics board approved the study. Informed consent was obtained from all individual participants included in the study. We have full control of all primary data and we agree to allow the journal to review our data if requested.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

520_2019_5175_MOESM1_ESM.docx (303 kb)
ESM 1 (DOCX 303 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Lawson Eng
    • 1
    • 2
    • 3
  • Devon Alton
    • 1
    • 2
    • 3
    • 4
  • Yuyao Song
    • 2
    • 5
  • Jie Su
    • 2
    • 5
  • Qihuang Zhang
    • 5
  • Jiahua Che
    • 5
  • Delaram Farzanfar
    • 2
  • Rahul Mohan
    • 2
  • Olivia Krys
    • 2
  • Katie Mattina
    • 1
    • 2
  • Christopher Harper
    • 1
    • 2
  • Sophia Liu
    • 1
    • 2
  • Tom Yoannidis
    • 6
  • Robin Milne
    • 2
    • 4
  • Nazek Abdelmutti
    • 4
  • M. Catherine Brown
    • 2
  • Ashlee Vennettilli
    • 2
  • Andrew J. Hope
    • 4
  • Doris Howell
    • 2
  • Jennifer M Jones
    • 2
  • Peter Selby
    • 7
    • 8
  • William K Evans
    • 9
  • Wei Xu
    • 2
    • 3
    • 10
  • David Paul Goldstein
    • 6
  • Meredith Elana Giuliani
    • 2
    • 4
    Email author
  • Geoffrey Liu
    • 1
    • 2
    • 3
    • 10
    Email author
  1. 1.Division of Medical Oncology and Hematology, Department of MedicinePrincess Margaret Cancer Centre/University Health Network and University of TorontoTorontoCanada
  2. 2.Ontario Cancer InstituteTorontoCanada
  3. 3.Department of MedicineUniversity Health NetworkTorontoCanada
  4. 4.Department of Radiation OncologyPrincess Margaret Cancer CentreTorontoCanada
  5. 5.Department of BiostatisticsPrincess Margaret Cancer Centre/University Health Network and University of TorontoTorontoCanada
  6. 6.Department of Otolaryngology-Head and Neck SurgeryUniversity of Toronto, University Health NetworkTorontoCanada
  7. 7.Centre for Addiction and Mental HealthUniversity of TorontoTorontoCanada
  8. 8.Departments of Family and Community Medicine & PsychiatryUniversity of TorontoTorontoCanada
  9. 9.Division of Medical Oncology, Department of OncologyMcMaster UniversityHamiltonCanada
  10. 10.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

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