Journal of Cancer Survivorship

, Volume 12, Issue 6, pp 828–834 | Cite as

Correlates of smoking status in cancer survivors

  • Melissa A. LittleEmail author
  • Robert C. Klesges
  • Zoran Bursac
  • Jennifer P. Halbert
  • Jon Ebbert
  • Gerald W. Talcott
  • Benny Weksler



To determine the characteristics associated with cancer survivors which indicate continued cigarette smoking at or around the time of cancer diagnosis.


A total of 631 survivors were recruited in four cancer centers in Memphis, TN, between March 2015 and June 2016. To increase the probability of accurate reporting, surveys were conducted anonymously. A total of 112 respondents reported they were current smokers and 202 reported they were former smokers (n = 314), who comprised the sample.


We found that the rate of daily e-cigarette use among cancer survivors who smoked was 15.2% versus 3.9% in cancer survivors who no longer smoked. The national rate of adult e-cigarette use is 3.5%. Multivariate models correlated the characteristics of current versus former smokers and revealed that increasing age (aOR = 0.97, p < .0001), decreasing education (aOR = 2.39, p < .02), and current use of e-cigarettes (aOR = 3.74, p < .00045) were frequently associated with current cigarette smoking.


While age and gender were associated with continued smoking, current use of e-cigarettes was associated with almost four times higher odds of being a current smoker. Further research is needed to determine if use of e-cigarettes deters or promotes the smoking cessation process, at least in cancer survivors.

Implications for Cancer Survivors

Among cancer survivors who continue to smoke after a cancer diagnosis, use of e-cigarettes is highly prevalent; research is needed to determine whether use of e-cigarettes promotes, has no effect, or hinders smoking cessation efforts among this vulnerable population.


Smoking cessation e-cigarettes Tobacco use Cancer survivors who smoke 



The authors gratefully acknowledge Methodist Health Systems and the West Cancer Center for their assistance in providing access to their facilities and patients.

Funding information

This study was supported by a grant from the National Cancer Institute (R01CA127964) awarded to the Dr. Klesges, as well as funding from the University of Virginia Center for Addiction Prevention Research.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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. This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Melissa A. Little
    • 1
    Email author
  • Robert C. Klesges
    • 2
  • Zoran Bursac
    • 3
  • Jennifer P. Halbert
    • 2
  • Jon Ebbert
    • 4
  • Gerald W. Talcott
    • 1
  • Benny Weksler
    • 5
  1. 1.Center for Addiction and Prevention ResearchUniversity of Virginia Medical SchoolLackland AFBUSA
  2. 2.Center for Addiction and Prevention Research, Department of Public Health SciencesUniversity of VirginiaCharlottesvilleUSA
  3. 3.Division of Biostatistics, Department of Preventive MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  4. 4.Mayo ClinicRochesterUSA
  5. 5.University of Tennessee Health Science CenterMemphisUSA

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