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Surgical lung cancer patients’ views about smoking and support to quit after diagnosis: a qualitative study

Abstract

Purpose

Evidence suggests that quitting smoking improves symptoms as well as disease-related mortality for cancer patients. However, smoking cessation support is typically not well integrated into routine cancer care even in the case of lung cancer.. We explored surgical lung cancer patients’ views about smoking and about their preferences for support to help them to quit.

Methods

We conducted semi-structured, qualitative interviews with 22 surgical lung cancer patients with a smoking history, after treatment with surgery. Data were analysed using the framework approach.

Results

Although diagnosis promoted a successful quit attempt in some, others continued smoking or relapsed after a quit attempt. Most participants wished they were a non-smoker but, in conflict with this, also felt that smoking was enjoyable, helped with psychological coping or had some health benefits. Some also demonstrated a fatalist attitude towards the potential detrimental health effects. However, all participants felt that it was important for health professionals to address smoking and some wanted cessation support although it was often not provided. Participants wanted support to start as early as possible and to continue for the first weeks after discharge.

Conclusions

Surgical lung cancer patients often stop smoking during hospitalisation, and many want to remain quit but relapse shortly after discharge. Although it is often not provided, many patients want to be offered support to help them quit.

Implications for Cancer Survivors

Surveys suggest that clinicians believe that addressing smoking will be difficult and/or unwanted. However, these findings suggest that surgical lung cancer patients would tolerate, and most would prefer, integration of smoking cessation support into routine cancer care.

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Compliance with ethical standards

Prof. Aveyard reports grants from UK Centre for Tobacco Control Studies (UKCRC) and grants from NIHR School for Primary Care Research, during the conduct of the study; and personal fees from Pfizer and personal fees from McNeil, outside the submitted work. Amanda Farley reports grants from UK Centre for Tobacco Control Studies (UKCRC) and grants from NIHR School for Primary Care Research, during the conduct of the study. Babu Naidu reports grants from NIHR School for Primary Care Research, during the conduct of the study. Amy Kerr and George Dowswell report no support from any organisation for the submitted work, no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years and no other relationships or activities that could appear to have influenced the submitted work. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. We were granted ethical approval by the Birmingham, East, North and Solihull Research Ethics Committee (REC ref no: 09/H1206/4). Informed consent was obtained from all individual participants included in the study.

Funding

The study was funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR). AF and PA were also part funded by The UK Centre for Tobacco and Alcohol Studies, a UKCRC Public Health Research: Centre of Excellence. Funding from British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council and the Department of Health, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Conflict of interest

Prof. Aveyard reports grants from UK Centre for Tobacco and Alcohol Studies (UKCRC) (Grant number: MRC MR/k/023195/1) and the NIHR School for Primary Care Research (grant number: 2.69) and one day consultancy for Pfizer on smoking cessation in 2012 which led to a payment to him and the University of Oxford; Amanda Farley and Babu Naidu report a grant from NIHR School for Primary Care Research (grant number: 2.69); Amy Kerr and George Dowswell declare that they have no conflicts of interest.

Author information

Correspondence to Amanda Farley.

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Farley, A., Aveyard, P., Kerr, A. et al. Surgical lung cancer patients’ views about smoking and support to quit after diagnosis: a qualitative study. J Cancer Surviv 10, 312–319 (2016) doi:10.1007/s11764-015-0477-4

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Keywords

  • Smoking cessation
  • Lung cancer
  • Patient preferences
  • Qualitative