Patterns of cigarette smoking and alcohol drinking among Canadian adults with cancer in a contemporary national cohort

Abstract

Objective

To evaluate the patterns of cigarette smoking and alcohol drinking among Canadian adults with cancer in a contemporary national cohort.

Methods

Canadian Community Health Survey (CCHS) annual surveys (2007–2016) were accessed, and cancer patients (identified by the question: Do you have cancer?) with complete information regarding smoking and alcohol drinking were included in the current analysis. Multivariable logistic regression analyses were conducted to evaluate factors associated with current smoking and alcohol drinking habits.

Results

A total of 15,168 adult patients with cancer with complete information about smoking history and alcohol drinking in the past 12 months were included in the current analysis. Fifteen percent of patients were current smokers at the time of survey completion, and 3.2% exceed national limits for alcohol drinking. The following factors were associated with current smoking: younger age (OR: 2.42; 95% CI: 1.54–3.82), common-law partnership (OR versus single status: 2.61; 95% CI: 1.62–4.18), lower income (OR for patients with income <20,000 versus patients with income >80,000: 3.19; 95% CI: 2.26–4.49), poor self-perceived health (OR for excellent versus poor self-perceived health: 0.52; 95% CI: 0.33–0.83), poor self-perceived mental health (OR for excellent versus poor self-perceived mental health: 0.47; 95% CI: 0.29–0.78), heavy alcohol drinking (OR for no heavy alcohol drinking versus heavy alcohol drinking: 0.41; 95% CI: 0.29–0.58), and illicit drug use (OR: 2.42; 95% CI: 1.96–2.98). The following factors are associated with alcohol drinking beyond recommended levels: male sex (OR: 1.59; 95% CI: 1.18–2.14), heavy smoking status (OR for non-smokers versus heavy smokers: 0.30; 95% CI: 0.19–0.48), and illicit drug use (OR: 2.71; 95% CI: 1.96–3.74).

Conclusions

Current smoking and alcohol drinking are not uncommon among Canadian adults with cancer. Further efforts focusing on smoking cessation and alcohol moderation are needed.

Implications for cancer survivors

Coordinated national and provincial efforts are needed to address cigarette smoking and heavy alcohol drinking among individuals with history of cancer.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    Paull DE, Updyke GM, Baumann MA, Chin HW, Little AG, Adebonojo SA. Alcohol abuse predicts progression of disease and death in patients with lung cancer. Ann Thorac Surg. 2005;80(3):1033–9.

    Article  Google Scholar 

  2. 2.

    Paull DE, Updyke GM, Davis CA, Adebonojo SA. Complications and long-term survival for alcoholic patients with resectable lung cancer. Am J Surg. 2004;188(5):553–9.

    Article  Google Scholar 

  3. 3.

    Abdel-Rahman O, Cheung WY. Impact of smoking history on the outcomes of women with early-stage breast cancer: a secondary analysis of a randomized study. Med Oncol. 2018;35(5):68.

    Article  Google Scholar 

  4. 4.

    Abdel-Rahman O, Helbling D, Schob O, Eltobgy M, Mohamed H, Schmidt J, et al. Cigarette smoking as a risk factor for the development of and mortality from hepatocellular carcinoma: an updated systematic review of 81 epidemiological studies. J Evid Based Med. 2017;10(4):245–54.

    Article  Google Scholar 

  5. 5.

    https://www.statcan.gc.ca/eng/survey/household/3226. Last accessed on 31/12/2019.

  6. 6.

    Statistics Canada Canadian Community Health Survey, available at http://www.statcan.gc.ca/cgi-bin/imdb/p2SV.pl?Function=getSurvey&SDDS=3226⟨=en&db=imdb&adm=8&dis=2

  7. 7.

    https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article/00003-eng.htm. Last accessed 4/12/2020.

  8. 8.

    Vozoris NT, Stanbrook MB. Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma. Respir Med. 2011;105(3):477–84.

    Article  Google Scholar 

  9. 9.

    Ejsing LK, Becker U, Tolstrup JS, Flensborg-Madsen T. Physical activity and risk of alcohol use disorders: results from a prospective cohort study. Alcohol Alcohol. 2015;50(2):206–12.

    CAS  Article  Google Scholar 

  10. 10.

    https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/research/tobacco-use-statistics/terminology.html. Last accessed on 14/1/2020.

  11. 11.

    https://ccsa.ca/canadas-low-risk-alcohol-drinking-guidelines-brochure. Last accessed on 14/1/2020.

  12. 12.

    Klatsky AL, Armstrong MA, Friedman GD. Relations of alcoholic beverage use to subsequent coronary artery disease hospitalization. Am J Cardiol. 1986;58(9):710–4.

    CAS  Article  Google Scholar 

  13. 13.

    Abdel-Rahman O. Impact of NCI socioeconomic index on the outcomes of nonmetastatic breast cancer patients: analysis of SEER census tract-level socioeconomic database. Clin Breast Cancer. 2019;19(6):e717–e22.

    Article  Google Scholar 

  14. 14.

    Abdel-Rahman O. Outcomes of non-metastatic colon cancer patients in relationship to socioeconomic status: an analysis of SEER census tract-level socioeconomic database. Int J Clin Oncol. 2019;24(12):1582–7.

    Article  Google Scholar 

  15. 15.

    Abdel-Rahman O. Pre-diagnostic body mass index trajectory in relationship to lung cancer incidence and mortality; findings from the PLCO trial. Expert Rev Respir Med. 2019;13(10):1029–35.

    CAS  Article  Google Scholar 

  16. 16.

    Sanford NN, Sher DJ, Xu X, Ahn C, D'Amico AV, Aizer AA, et al. Alcohol use among patients with cancer and survivors in the United States, 2000-2017. J Natl Compr Cancer Netw. 2020;18(1):69–79.

    Article  Google Scholar 

  17. 17.

    Downer MK, Kenfield SA, Stampfer MJ, Wilson KM, Dickerman BA, Giovannucci EL, et al. Alcohol intake and risk of lethal prostate cancer in the health professionals follow-up study. J Clin Oncol. 2019;37(17):1499–511.

    CAS  Article  Google Scholar 

  18. 18.

    Loprinzi PD. Factors influencing the disconnect between self-perceived health status and actual health profile: implications for improving self-awareness of health status. Prev Med. 2015;73:37–9.

    Article  Google Scholar 

  19. 19.

    Abdel-Rahman O. Cannabis use among Canadian adults with cancer (2007-2016); results from a national survey. Expert Rev Pharmacoecon Outcomes Res. 2020.

  20. 20.

    Lofters A, Vahabi M, Glazier RH. The validity of self-reported cancer screening history and the role of social disadvantage in Ontario, Canada. BMC Public Health. 2015;15:28-.

  21. 21.

    Akhtar-Danesh N, Dehghan M, Merchant AT, Rainey JA. Validity of self-reported height and weight for measuring prevalence of obesity. Open Med. 2008;2(3):e83–e8.

    PubMed  PubMed Central  Google Scholar 

  22. 22.

    Ramaswamy AT, Toll BA, Chagpar AB, Judson BL. Smoking, cessation, and cessation counseling in patients with cancer: a population-based analysis. Cancer. 2016;122(8):1247–53.

    Article  Google Scholar 

  23. 23.

    Xiao R, Pham Y, Ward MC, Houston N, Reddy CA, Joshi NP, et al. Impact of active smoking on outcomes in HPV+ oropharyngeal cancer. Head Neck. 2019.

  24. 24.

    Platek AJ, Jayaprakash V, Merzianu M, Platek ME, Cohan DM, Hicks WL Jr, et al. Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation. Laryngoscope. 2016;126(12):2733–8.

    Article  Google Scholar 

  25. 25.

    Mayadev J, Li CS, Lim J, Valicenti R, Alvarez EA. Alcohol abuse decreases pelvic control and survival in cervical cancer: an opportunity of lifestyle intervention for outcome improvement. Am J Clin Oncol. 2017;40(5):451–7.

    Article  Google Scholar 

  26. 26.

    LoConte NK, Brewster AM, Kaur JS, Merrill JK, Alberg AJ. Alcohol and Cancer: a statement of the American Society of Clinical Oncology. J Clin Oncol. 2018;36(1):83–93.

    CAS  Article  Google Scholar 

Download references

Acknowledgements

This study is based on CCHS datasets which are publicly available datasets collected by StatCan.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Omar Abdel-Rahman.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

ESM 1

(DOCX 778 kb)

ESM 2

(DOCX 19 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Abdel-Rahman, O. Patterns of cigarette smoking and alcohol drinking among Canadian adults with cancer in a contemporary national cohort. J Cancer Surviv (2021). https://doi.org/10.1007/s11764-021-00992-1

Download citation

Keywords

  • Smoking
  • Alcohol
  • Cancer
  • Adults
  • Canada