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.
Similar content being viewed by others
References
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.
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.
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.
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.
https://www.statcan.gc.ca/eng/survey/household/3226. Last accessed on 31/12/2019.
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
https://www150.statcan.gc.ca/n1/pub/82-625-x/2020001/article/00003-eng.htm. Last accessed 4/12/2020.
Vozoris NT, Stanbrook MB. Smoking prevalence, behaviours, and cessation among individuals with COPD or asthma. Respir Med. 2011;105(3):477–84.
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.
https://www.canada.ca/en/health-canada/services/health-concerns/tobacco/research/tobacco-use-statistics/terminology.html. Last accessed on 14/1/2020.
https://ccsa.ca/canadas-low-risk-alcohol-drinking-guidelines-brochure. Last accessed on 14/1/2020.
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.
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.
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.
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.
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.
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.
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.
Abdel-Rahman O. Cannabis use among Canadian adults with cancer (2007-2016); results from a national survey. Expert Rev Pharmacoecon Outcomes Res. 2020.
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-.
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.
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.
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.
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.
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.
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.
Acknowledgements
This study is based on CCHS datasets which are publicly available datasets collected by StatCan.
Author information
Authors and Affiliations
Corresponding author
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.
Rights and permissions
About this article
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 17, 130–138 (2023). https://doi.org/10.1007/s11764-021-00992-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11764-021-00992-1