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Hawari FI, Abu Alhalawa MA, Alshraiedeh RH, Al Nawaiseh AM, Khamis A, Dodin YI, Obeidat NA. Supporting Smokers in Difficult Settings: Suggestions for Better Education and Counseling in Cancer Centers in Jordan. Curr Oncol 2022; 29:9335-9348. [PMID: 36547146 PMCID: PMC9776699 DOI: 10.3390/curroncol29120732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/14/2022] [Accepted: 11/21/2022] [Indexed: 12/02/2022] Open
Abstract
Continued smoking in cancer patients is commonly observed in Jordan. In a country that exhibits some of the highest smoking rates globally, enhancing patient education regarding the value of smoking cessation for cancer care is vital. The objectives of our study were to describe sociodemographic and clinical factors associated with continued smoking in Jordanian smokers after a cancer diagnosis; to identify reasons for smoking and knowledge regarding smoking's impact on care; to examine in a multivariable manner the factors associated with continued smoking, and to accordingly generate patient counseling recommendations. An interviewer-administered survey using the Theoretical Domains Framework was employed. Among 350 subjects (mean age 51.0, median 52.7), approximately 38% of patients had quit or were in the process of quitting; 61.7% remained smokers. Substantial knowledge gaps with regard to the impact of continued smoking on cancer care were observed. Remaining a smoker after diagnosis was associated with being employed, not receiving chemotherapy or surgery, having lower confidence in quitting, and having a lower number of identified reasons for smoking. Interventions to promote cessation in Jordanian cancer patients who smoke should focus on enhancing patient awareness about the impact of smoking in cancer care and raising perceived self-efficacy to quit.
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Affiliation(s)
- Feras I. Hawari
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan
- Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Rasha H. Alshraiedeh
- Faculty of Pharmacy, The University of Jordan, Amman 11972, Jordan
- Volunteer Research Program at King Hussein Cancer Center, Amman11941, Jordan
| | - Ahmad M. Al Nawaiseh
- Volunteer Research Program at King Hussein Cancer Center, Amman11941, Jordan
- Faculty of Medicine, The University of Jordan, Amman 11972, Jordan
| | - Alia Khamis
- Volunteer Research Program at King Hussein Cancer Center, Amman11941, Jordan
- Faculty of Medicine, The University of Jordan, Amman 11972, Jordan
| | - Yasmeen I. Dodin
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan
| | - Nour A. Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan
- Correspondence: ; Tel.: +962-6-5300460 (ext. 2204); Fax: +962-6-5345567
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Jose T, Schroeder DR, Warner DO. Changes in Cigarette Smoking Behavior in Cancer Survivors During Diagnosis and Treatment. Nicotine Tob Res 2022; 24:1581-1588. [PMID: 35311999 PMCID: PMC9575979 DOI: 10.1093/ntr/ntac072] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 02/25/2022] [Accepted: 03/18/2022] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Continued cigarette smoking is a critical determinant of outcome in oncology patients, but how the separate events of cancer diagnosis, cancer treatment, and completion of treatment affect smoking behavior in cancer survivors is unknown. This study described such changes, hypothesizing that they would be more pronounced for smoking-related cancers. METHODS The Cancer Patient Tobacco Use Questionnaire (CTUQ) was sent to every cancer patient ≥ 18 y old scheduled for outpatient visits at the Mayo Clinic Cancer Center with a current or former history of tobacco use. RESULTS From September 2019 to September 2020, 33,831 patients received the CTUQ, and 20,818 (62%) responded. Of the 3007 current smokers analyzed, 34% quit at diagnosis; those with smoking-related cancers were more likely to quit (40% vs. 29%, respectively, p < .001). Among those who did not quit at diagnosis, 31% quit after starting cancer treatment, and those with smoking-related cancers were more likely to quit (35% and 28%, respectively, p = .002) Among those who had quit before the completion of treatment, 13% resumed smoking after treatment ended. In multivariable analysis, patients with smoking-related cancers were more likely to report 30-d point prevalence abstinence from pre-diagnosis to the completion of treatment (adjusted OR 1.98 [95% CI 1.65, 2.36], p < .001). CONCLUSIONS Both cancer diagnosis and treatment prompt smoking abstinence, with most maintaining abstinence after treatment is completed. Those with smoking-related cancers are more likely to quit. These results emphasize the need to provide access to tobacco treatment services that can further support cancer patients who smoke. IMPLICATIONS Approximately one-third of cancer patients who smoke quit smoking at the time of diagnosis, an additional one-third of patients who had not yet quit did so at the initiation of treatment, and most sustained this abstinence after treatment completion. Patients with smoking-related cancers are more likely to quit. Thus, there are multiple opportunities within the cancer care continuum to intervene and support quit attempts or continued abstinence.
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Affiliation(s)
- Thulasee Jose
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - David O Warner
- Corresponding Author: David O. Warner, MD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA. Telephone: 507-255-4288; E-mail:
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Hawari FI, Abu Alhalawa MA, Alshrideh RH, Al Nawaiseh AM, Khamis A, Dodin YI, Obeidat NA. Cessation experiences and quitting perspectives of Jordanian cancer patients who smoke. Cancer Epidemiol 2022; 79:102207. [PMID: 35759876 DOI: 10.1016/j.canep.2022.102207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVES To describe quitting experiences of cancer patients in a Cancer Center in Jordan; to study patients' perceptions regarding the process of smoking cessation; and to provide insights about patients in this difficult setting in order to inform oncology practitioners with regards to how improve perceptions and skills related to quitting. METHODS An Arabic cross-sectional questionnaire was developed to evaluate smoking and quitting behaviors in the context of cancer. The tool used as its framework the Theoretical Domains Framework to capture quitting perceptions of cancer patients who smoke, as well as social, environmental, and system-level factors that influence quitting. Eligible patients who were treated at the Center (both in-patient and out-patient settings) and who were current smokers or who smoked up to the time of cancer diagnosis were eligible. Patients were interviewed between July, 2018 and January 2020 using two versions of the questionnaire: an 'ex-smokers' version, and a 'current smokers' version. RESULTS Only a third of subjects (104/350) had been smoke-free for at least 30 days. Both smokers and ex-smokers generally felt that quitting was important, but mean importance and confidence scores (out of 10) were significantly lower in current smokers (8.2 versus 9.1, p-value=0.002; 6.4 versus 8.7, p-value=0.000). Roughly 31% of subjects believed smoking harms were exaggerated and that smoking was not an addiction. About 62% of subjects agreed quitting required skills, and 78.5% felt the steps to quit were clear, but across several listed strategies for quitting, use of these was limited (even in ex-smokers). Among current smokers, roughly a third exhibited forms of cessation fatigue. CONCLUSION Jordanian cancer patients who smoke present with limited knowledge about the quitting process. Even when some success is observed, low rates of utilization of specific quitting strategies were observed, highlighting the need for better counseling about quitting.
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Affiliation(s)
- Feras I Hawari
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan; Section of Pulmonary and Critical Care, Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Rasha H Alshrideh
- Pharmacy Student, University of Jordan, Amman 11972, Jordan; Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan
| | - Ahmad M Al Nawaiseh
- Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan; Medical Student, University of Jordan, Amman 11972, Jordan
| | - Alia Khamis
- Volunteer Research Program at King Hussein Cancer Center, Amman 11941, Jordan; Medical Student, University of Jordan, Amman 11972, Jordan
| | - Yasmeen I Dodin
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan
| | - Nour A Obeidat
- Cancer Control Office, King Hussein Cancer Center, Amman 11941, Jordan.
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Wang R, Li S, Wen W, Zhang J. Multi-Omics Analysis of the Effects of Smoking on Human Tumors. Front Mol Biosci 2021; 8:704910. [PMID: 34796198 PMCID: PMC8592943 DOI: 10.3389/fmolb.2021.704910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/15/2021] [Indexed: 12/13/2022] Open
Abstract
Comprehensive studies on cancer patients with different smoking histories, including non-smokers, former smokers, and current smokers, remain elusive. Therefore, we conducted a multi-omics analysis to explore the effect of smoking history on cancer patients. Patients with smoking history were screened from The Cancer Genome Atlas database, and their multi-omics data and clinical information were downloaded. A total of 2,317 patients were included in this study, whereby current smokers presented the worst prognosis, followed by former smokers, while non-smokers showed the best prognosis. More importantly, smoking history was an independent prognosis factor. Patients with different smoking histories exhibited different immune content, and former smokers had the highest immune cells and tumor immune microenvironment. Smokers are under a higher incidence of genomic instability that can be reversed following smoking cessation in some changes. We also noted that smoking reduced the sensitivity of patients to chemotherapeutic drugs, whereas smoking cessation can reverse the situation. Competing endogenous RNA network revealed that mir-193b-3p, mir-301b, mir-205-5p, mir-132-3p, mir-212-3p, mir-1271-5p, and mir-137 may contribute significantly in tobacco-mediated tumor formation. We identified 11 methylation driver genes (including EIF5A2, GBP6, HGD, HS6ST1, ITGA5, NR2F2, PLS1, PPP1R18, PTHLH, SLC6A15, and YEATS2), and methylation modifications of some of these genes have not been reported to be associated with tumors. We constructed a 46-gene model that predicted overall survival with good predictive power. We next drew nomograms of each cancer type. Interestingly, calibration diagrams and concordance indexes are verified that the nomograms were highly accurate for the prognosis of patients. Meanwhile, we found that the 46-gene model has good applicability to the overall survival as well as to disease-specific survival and progression-free intervals. The results of this research provide new and valuable insights for the diagnosis, treatment, and follow-up of cancer patients with different smoking histories.
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Affiliation(s)
- Rui Wang
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Shanshan Li
- Department of Nursing, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Wen Wen
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Jianquan Zhang
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
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Hou K, Deng B, Liu A, Ran J. Measurement of harmful nanoparticle distribution among filters, smokers' respiratory systems, and surrounding air during cigarette smoking. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2021; 56:1058-1068. [PMID: 34353208 DOI: 10.1080/10934529.2021.1962158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
This study was undertaken to investigate the filtration effect of filter on nanoparticle and the deposition behavior of nanoparticle in the human respiratory system from the aspect of nanoparticle number during cigarette smoking. For that, two kinds of experiments were designed. One is machine experiment, a well-controlled simulated respiratory system was designed to measure the raw emission and filter effect. Another is human experiment, volunteers were asked to inhale smoke into the oral cavity only and lungs, respectively, to distinguish smoke path. Results revealed that effective inhaled nanoparticle amount of a Taishan and a Hongtaishan cigarette were 5.8E + 9 (#) and 9.4E + 7 (#), respectively. The filter's integrated reduction rate was 41.65% for nanoparticle. For Taishan cigarette, 35.4% and 41.7% of raw emitted nanoparticles were deposited in the oral cavity and lungs, respectively, the rest of 22.9% was exhaled to surrounding air. The corresponding values were 25.6%, 41.5% and 32.9%, respectively, for Hongtaishan. The current findings are expected to provide basic assessments of filter effect and harm to human and to be a warning for smokers.
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Affiliation(s)
- Kaihong Hou
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Banglin Deng
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Aodong Liu
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
| | - Jiaqi Ran
- College of Mechatronics and Control Engineering, Shenzhen University, Shenzhen, China
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