Journal of Cancer Survivorship

, Volume 6, Issue 3, pp 333–344

Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis

  • J. Michael Underwood
  • Julie S. Townsend
  • Eric Tai
  • Arica White
  • Shane P. Davis
  • Temeika L. Fairley



People who continue to smoke after a cancer diagnosis have an increased risk for recurrences or development of new malignancies. These risks may be even higher among tobacco-related cancer survivors (TRCS). We describe tobacco use behaviors among TRCS, other cancer survivors, and people without a history of cancer.


We used 2009 Behavioral Risk Factor Surveillance System data to describe demographic characteristics, smoking history, current smoking prevalence, and smokeless tobacco use among TRCS, other cancer survivors, and people without a history of cancer (cigarette smoking and smokeless tobacco use were calculated after adjusting for age, sex, race, and insurance status). Tobacco-related cancers were defined as lung/bronchial, pharyngeal, laryngeal, esophageal, stomach, pancreatic, kidney/renal, urinary bladder, cervical, and acute myeloid leukemia.


A total of 20 % of all cancer survivors were TRCS. TRCS were primarily female (68 %) and white (78 %). Smoking prevalence was higher among TRCS (27 %) compared with other cancer survivors (16 %) and respondents without a history of cancer (18 %). Smokeless tobacco use was higher among respondents without a history of cancer (4 %) compared with TRCS (3 %) and other cancer survivors (3 %).


The self-reported smoking prevalence among TRCS is higher than among other cancer survivors and people without a history of cancer. Targeted smoking prevention and cessation interventions are needed for cancer survivors, especially those diagnosed with a tobacco-related cancer.

Implications for cancer survivors

We recommend all cancer survivors be made aware of the health risks associated with smoking after a cancer diagnosis, and smoking cessation services be offered to those who currently smoke.

Condensed abstract

We provide the first population-based report on demographic characteristics and tobacco use behaviors among self-reported tobacco-related cancer survivors.


Tobacco Epidemiology Survivors Neoplasms Second Primary 


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Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2012

Authors and Affiliations

  • J. Michael Underwood
    • 1
  • Julie S. Townsend
    • 1
  • Eric Tai
    • 1
  • Arica White
    • 1
  • Shane P. Davis
    • 2
  • Temeika L. Fairley
    • 1
  1. 1.Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Office on Smoking and Health, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA

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