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Disparities in smoking and cessation status among cancer survivors and non-cancer individuals: a population-based study from National Health and Nutrition Examination Survey

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Abstract

Introduction

Continued smoking after a cancer diagnosis is a critical problem. This study examined smoking prevalence among all and specific cancer survivors, and compared demographic profiles of the current smokers between cancer and non-cancer individuals.

Methods

We used data from 2,188 cancer survivors and 22,441 non-cancer individuals who participated in the 10-year National Health and Nutrition Examination Survey (NHANES 1999–2008). All analyses were weighted to represent the United States population.

Results

The current smoking rates decreased as age increased in both cancer and non-cancer populations. The smoking rate was higher in young cancer survivors (age <=40) than in young non-cancer individuals. The cervical, colon cancer and melanoma survivors had higher age-adjusted smoking rates than survivors of other cancers. For non-cancer individuals, the results showed that poorer white males with lower educational levels, with widowed, divorced, or separated marital status, who were underweight and had at least 12 alcoholic beverages a year, were more likely to be current smokers.

Discussions/conclusions

We can observe that age, race, education, marital status, and year since cancer diagnosis were important predictors of smoking status in cancer survivors based on the results of multivariable modeling and comparisons of age-adjusted smoking rates in specific cancer sub-groups. This implies that developing smoking cessation programs for cervical cancer and melanoma is of particularly high priority because survivors of these cancers had relatively high smoking rates and low quit smoking rates after diagnosis. These efforts should improve their quality of life and health status as well as reduce smoking-related health disparities.

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References

  1. Marshall L, Schooley M, Ryan H, Cox P, Easton A, Healton C, et al. Youth tobacco surveillance–United States, 2001–2002. MMWR Surveill Summ. 2006;55:1–56.

    PubMed  Google Scholar 

  2. A Report of the Surgeon General. Executive summary. Tobacco use among U.S. racial/ethnic minority groups–African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, Hispanics. MMWR Recomm Rep. 1998;47:1–16.

    Google Scholar 

  3. American Cancer Society. Cancer Facts & Figures 2007. Atlanta: American Cancer Society; 2007.

    Google Scholar 

  4. Hamajima N, Hirose K, Tajima K, Rohan T, Calle EE, Heath Jr CW, et al. Alcohol, tobacco and breast cancer–collaborative reanalysis of individual data from 53 epidemiological studies, including 58, 515 women with breast cancer and 95, 067 women without the disease. Br J Cancer. 2002;87:1234–45.

    Article  PubMed  Google Scholar 

  5. Baron JA. Smoking and estrogen-related disease. Am J Epidemiol. 1984;119:9–22.

    CAS  PubMed  Google Scholar 

  6. Fink AK, Lash TL. A null association between smoking during pregnancy and breast cancer using Massachusetts registry data (United States). Cancer Causes Control. 2003;14:497–503.

    Article  PubMed  Google Scholar 

  7. Cui Y, Miller AB, Rohan TE. Cigarette smoking and breast cancer risk: update of a prospective cohort study. Breast Cancer Res Treat. 2006;100:293–9.

    Article  PubMed  Google Scholar 

  8. Nagata C, Mizoue T, Tanaka K, Tsuji I, Wakai K, Inoue M, et al. Tobacco smoking and breast cancer risk: an evaluation based on a systematic review of epidemiological evidence among the Japanese population. Jpn J Clin Oncol. 2006;36:387–94.

    Article  PubMed  Google Scholar 

  9. Gram IT, Braaten T, Terry PD, Sasco AJ, Adami HO, Lund E, et al. Breast cancer risk among women who start smoking as teenagers. Cancer Epidemiol Biomark Prev. 2005;14:61–6.

    Google Scholar 

  10. Fentiman IS, Allen DS, Hamed H. Smoking and prognosis in women with breast cancer. Int J Clin Pract. 2005;59:1051–4.

    Article  CAS  PubMed  Google Scholar 

  11. Manjer J, Andersson I, Berglund G, Bondesson L, Garne JP, Janzon L, et al. Survival of women with breast cancer in relation to smoking. Eur J Surg. 2000;166:852–8.

    Article  CAS  PubMed  Google Scholar 

  12. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007;57:43–66.

    Article  PubMed  Google Scholar 

  13. Ostroff JS, Jacobsen PB, Moadel AB, Spiro RH, Shah JP, Strong EW, et al. Prevalence and predictors of continued tobacco use after treatment of patients with head and neck cancer. Cancer. 1995;75:569–76.

    Article  CAS  PubMed  Google Scholar 

  14. Demark-Wahnefried W, Peterson B, McBride C, Lipkus I, Clipp E. Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas. Cancer. 2000;88:674–84.

    Article  CAS  PubMed  Google Scholar 

  15. Mayer DK, Terrin NC, Menon U, Kreps GL, McCance K, Parsons SK, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34:643–51.

    Article  PubMed  Google Scholar 

  16. Eakin EG, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, et al. Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control. 2007;18:881–94.

    Article  PubMed  Google Scholar 

  17. Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23:8884–93.

    Article  PubMed  Google Scholar 

  18. Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58:82–91.

    PubMed  Google Scholar 

  19. Coups EJ, Ostroff JS. A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med. 2005;40:702–11.

    Article  PubMed  Google Scholar 

  20. Cox LS, Africano NL, Tercyak KP, Taylor KL. Nicotine dependence treatment for patients with cancer. Cancer. 2003;98:632–44.

    Article  PubMed  Google Scholar 

  21. Yu GP, Ostroff JS, Zhang ZF, Tang J, Schantz SP. Smoking history and cancer patient survival: a hospital cancer registry study. Cancer Detect Prev. 1997;21:497–509.

    CAS  PubMed  Google Scholar 

  22. Richardson GE, Tucker MA, Venzon DJ, Linnoila RI, Phelps R, Phares JC, et al. Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers. Ann Intern Med. 1993;119:383–90.

    CAS  PubMed  Google Scholar 

  23. Clark TG, Murphy MF, Hey K, Drury M, Cheng KK, Aveyard P. Does smoking influence survival in cancer patients through effects on respiratory and vascular disease? Eur J Cancer Prev. 2006;15:87–90.

    Article  PubMed  Google Scholar 

  24. Aveyard P, Adab P, Cheng KK, Wallace DM, Hey K, Murphy MF. Does smoking status influence the prognosis of bladder cancer? A systematic review. BJU Int. 2002;90:228–39.

    Article  CAS  PubMed  Google Scholar 

  25. Khuri FR, Kim ES, Lee JJ, Winn RJ, Benner SE, Lippman SM, et al. The impact of smoking status, disease stage, and index tumor site on second primary tumor incidence and tumor recurrence in the head and neck retinoid chemoprevention trial. Cancer Epidemiol Biomark Prev. 2001;10:823–9.

    CAS  Google Scholar 

  26. Gritz ER, Fingeret MC, Vidrine DJ, Lazev AB, Mehta NV, Reece GP. Successes and failures of the teachable moment: smoking cessation in cancer patients. Cancer. 2006;106:17–27.

    Article  PubMed  Google Scholar 

  27. Ganz PA. A teachable moment for oncologists: cancer survivors, 10 million strong and growing. J Clin Oncol. 2005;23:5458–60.

    Article  PubMed  Google Scholar 

  28. Faeh D, Viswanathan B, Chiolero A, Warren W, Bovet P. Clustering of smoking, alcohol drinking and cannabis use in adolescents in a rapidly developing country. BMC Public Health. 2006;6:169.

    Article  PubMed  Google Scholar 

  29. Tseng TS, Lin HY. Gender and age disparity in health-related behaviors and behavioral patterns based on a National Survey of Taiwan. Int J Behav Med. 2008;15:14–20.

    Article  PubMed  Google Scholar 

  30. Canoy D, Wareham N, Luben R, Welch A, Bingham S, Day N, et al. Cigarette smoking and fat distribution in 21, 828 British men and women: a population-based study. Obes Res. 2005;13:1466–75.

    Article  PubMed  Google Scholar 

  31. Robb CA, Huston SJ, Finke MS. The mitigating influence of time preference on the relation between smoking and BMI scores. Int J Obes (Lond). 2008;32:1670–7.

    Article  CAS  Google Scholar 

  32. Centers for Disease Control and Prevention. (2005). Analytic and reporting guidelines, The National Health and Nutrition Examination Survey (NHANES). National Center for Health Statistics, Centers for Disease Control and Prevention Hyattsville, Maryland.

  33. American Cancer Society. Available at: http://www.cancer.org/docroot/cri/cri_2x.asp. Accessed October 10, 2008.

  34. American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.

    Google Scholar 

  35. National Center for Health Statistics. Continuous NHANES Web Tutorial- Specifying Weighting Parameters- How to Create Appropriate Subsets of Data for NHANES Analyses in SAS. Available at: http://www.cdc.gov/nchs/tutorials/Nhanes/SurveyDesign/Weighting/intro.htm. Accessed April 2009.

  36. Humpel N, Magee C, Jones SC. The impact of a cancer diagnosis on the health behaviors of cancer survivors and their family and friends. Support Care Cancer. 2007;15:621–30.

    Article  PubMed  Google Scholar 

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Acknowledgments

We appreciate anonymous reviewers for helpful suggestions and comments.

Author information

Authors and Affiliations

  1. School of Public Health, Louisiana State University Health Sciences Center, 1615 Poydras Street, Suite 1400, New Orleans, LA, 70112, USA

    Tung-Sung Tseng

  2. Biostatistics Department, Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Hui-Yi Lin

  3. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Michelle Y. Martin

  4. Department of Community Health Sciences, Tulane University, 1440 Canal Street, Suite 2300, New Orleans, LA, 70112, USA

    Ted Chen

  5. Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA

    Edward E. Partridge

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  1. Tung-Sung Tseng
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  2. Hui-Yi Lin
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Correspondence to Tung-Sung Tseng.

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Tseng, TS., Lin, HY., Martin, M.Y. et al. Disparities in smoking and cessation status among cancer survivors and non-cancer individuals: a population-based study from National Health and Nutrition Examination Survey. J Cancer Surviv 4, 313–321 (2010). https://doi.org/10.1007/s11764-010-0127-9

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  • DOI: https://doi.org/10.1007/s11764-010-0127-9

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