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Dhumal T, Kelly KM, Khadka S, Kelley GA, Kamal KM, Scott VG, Hogan TF, Harper FWK. Tobacco Cessation Interventions in Non-Respiratory Cancers: A Systematic Review With Meta-analysis of Randomized Controlled Trials. Ann Behav Med 2024; 58:579-593. [PMID: 38985846 DOI: 10.1093/abm/kaae040] [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] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Considering the high rates of persistent tobacco use, effective cessation interventions are needed for cancer patients and caregivers. Despite the need, there is a significant lack of research on tobacco cessation, especially for non-respiratory cancers (breast, prostate, colorectal, cervical, and bladder cancer). PURPOSE The objective was to evaluate tobacco use and tobacco cessation interventions among patients and caregivers for non-respiratory cancers. METHODS Randomized controlled trials assessing tobacco cessation interventions were identified. Five electronic databases were searched in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses guidelines through July 2023. Studies exclusive to lung, oral, thoracic, and head and neck cancers were excluded. Effect sizes were estimated; risk of bias was assessed. RESULTS Of 3,304 studies, 17 were included. Interventions included behavioral (n = 6), pharmacotherapy (n = 2), and a combination (n = 9) treatment. Eight studies included a health behavior model; mean behavioral change techniques were 5.57. Pooled magnitude of the odds of cessation was positive and significant (odds ratio = 1.24, 95% confidence interval [Lower Limit 1.02, Upper Limit 1.51]) relative to usual care/placebo. Cumulative meta-analysis examined the accumulation of results over-time and demonstrated that studies have been significant since 2020. Two studies included caregivers' who were involved in the provision of social support. CONCLUSIONS Current interventions have the potential to reduce tobacco use in non-respiratory cancers. Results may be beneficial for promoting tobacco cessation among non-respiratory cancers. There is a considerable lack of dyadic interventions for cancer survivors and caregivers; researchers are encouraged to explore dyadic approaches.
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Affiliation(s)
- Trupti Dhumal
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Kimberly M Kelly
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Safalta Khadka
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
- School of Public and Population Health and Department of Kinesiology, Boise State University, Boise, ID, USA
| | - Khalid M Kamal
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Virginia G Scott
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Thomas F Hogan
- Department of Medical Oncology, Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, USA
| | - Felicity W K Harper
- Department of Oncology, Karmanos Cancer Institute/Wayne State University School of Medicine, Detroit, MI, USA
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Nagappa B, Marimuthu Y, Ramaswamy G, Ganesan S, Pandjatcharam J, Thulasingam M, Kar SS. Continued tobacco use among tobacco-related head and neck cancer patients seeking care in a tertiary care facility, South India. Cancer Epidemiol 2023; 86:102434. [PMID: 37611484 DOI: 10.1016/j.canep.2023.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION Continued tobacco use in cancer patients leads to decreased treatment efficacy and safety, decreased survival, decreased quality of life, and an increased risk of cancer recurrence and primary tumours at other sites. OBJECTIVE To determine the prevalence of continued tobacco usage during the first 6 months of diagnosis among tobacco-related head and neck cancer patients seeking care from a tertiary care centre and the factors associated with it. METHODS A facility-based cohort study was conducted at a tertiary care centre in Puducherry, India. Newly diagnosed head and neck cancer patients aged > 18 years with a history of tobacco use were interviewed to gather information on their socio-demographic, clinical characteristics, and tobacco usage. All participants were interviewed again at the 3rd month and at the 6th month during their follow-up visit. The data were entered in EpiData v3.1 and analysed using STATA v14. Multivariable logistic regression analysis was done with continued tobacco use as the dependent variable and variables that were found significantly associated with continued tobacco use in univariate analysis. RESULTS Out of 220 study participants at baseline, 157(71 %; 95 % CI: 65.1-77.1) were using tobacco at the time of diagnosis. Out of these 157 participants, 80(50.9 %; 95 % CI; 43.1-58.7) continued to use tobacco at the 3rd month, 63(40.1 %: 95 % CI: 32.6-47.9) continued to use tobacco at the 6th month. The characteristics significantly associated with continued tobacco use are age (less than 39 years and more than 70 years), primary school education, nuclear family, and living alone, smoking tobacco, and increased duration of tobacco use. CONCLUSION Two-fifths of head and neck cancer patients with a history of tobacco use continued to use tobacco at the 6th month after diagnosis of cancer. Awareness of effects of tobacco use and the benefits of tobacco cessation needs to be created among cancer patients.
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Affiliation(s)
- Bharathnag Nagappa
- Department of Community Medicine, Sri Siddhartha Medical College and Hospital, Tumakuru, Karnataka 572107, India
| | - Yamini Marimuthu
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Mangalagiri, Guntur 522503, India
| | - Gomathi Ramaswamy
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bibinagar, Telangana 508126, India
| | | | | | | | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, JIPMER, Puducherry 605006, India
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Kim Y, Cho WK. Factors associated with successful smoking cessation in men with or without cardiovascular disease or cancer: Nationwide Korean population analysis. Tob Induc Dis 2023; 21:28. [PMID: 36814694 PMCID: PMC9940122 DOI: 10.18332/tid/159169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 01/02/2023] [Accepted: 01/10/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION This study was conducted to explore factors associated with smoking cessation in male smokers with cardiovascular disease (CVD) or cancer, the two leading causes of death worldwide, and to compare them with quitting factors in smokers without the two diseases. METHODS This is a secondary dataset analysis of the Korea National Health and Nutrition Examination Survey (KNHANES), nationally representative data from 2008-2019 (excluding 2013-2014), and included 12998 men without CVD or cancer (group without CVD or cancer), 1027 men with CVD (CVD group), and 616 men with cancer (cancer group). A Wald test with multiple logistic regression analysis was conducted. RESULTS The quitting success rates in the CVD and cancer groups were consistently higher than those in the group without CVD or cancer. Old age and willpower in the CVD group, and old age and being married in the cancer group were associated with quitting success. Secondhand smoking and methods of quitting other than willpower were related to quitting failure in both groups. When interaction effects between the groups were examined, household income was the only factor associated with successful cessation in the group without CVD or cancer (AOR=1.17, 1.18, and 1.40, among the second, third, and fourth highest income quartiles, respectively; p for interaction=0.023). Higher smoking amounts (AOR=0.85; p<0.001) and poor health perception (AOR=0.64; p=0.035) were associated with quitting failure in the group without CVD or cancer. However, no significant factor was detected related to smoking cessation in both the CVD and cancer groups when the interaction effect was investigated. CONCLUSIONS The quitting success rates in the CVD and cancer groups were higher, but no disease-specific quitting factors were identified. Therefore, being diagnosed with CVD or cancer itself could be inferred as a motive for quitting smoking.
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Affiliation(s)
- Youngmee Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Won-Kyung Cho
- International Healthcare Center, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea,Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Lang AE, MacMurdo M, Upson D. Increasing Access to Treatment for Nicotine Dependence. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Marshall ME, Shields CG, Alexander SC. "Do You Smoke?" Physician-Patient Conversations About Smoking and Lung Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1967-1974. [PMID: 34264511 DOI: 10.1007/s13187-021-02067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 06/13/2023]
Abstract
This study examined how physicians initiated and navigated conversations about smoking with patients with lung cancer. While there are numerous health benefits associated with smoking cessation in patients with advanced lung cancer, conversations about smoking cessation are infrequent and often lack tangible cessation support. We conducted a qualitative inductive content analysis on transcripts of conversations (n = 58) recorded during an initial appointment between a physician and a standardized patient (SP). SPs portrayed a 62-year-old male with lung cancer completing an initial visit with a new physician. Qualitative analysis focused on examining how physicians discussed smoking with a new patient. We found that a majority of physicians initiated conversations about smoking, often during the medical history charting process or during conversations about the lung cancer diagnosis. The content of conversations about smoking generally fits within six categories: assesses smoking status, builds smoking history profile, praises smoking cessation, connects smoking behaviors to diagnosis or treatment, provides empathy or understanding, and presents a negative bias about smoking. We found that while a majority of physicians asked patients about smoking, most physicians aimed for these conversations to be short, routine, and medically driven. Conversations about smoking were not tailored to meet the specific needs of patients with lung cancer, which might include additional provision of support for smoking cessation and recognition of smoking-related stigma.
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Affiliation(s)
- Mary E Marshall
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, CA, USA.
| | - Cleveland G Shields
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA
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Feuer Z, Michael J, Morton E, Matulewicz RS, Sheeran P, Shoenbill K, Goldstein A, Sherman S, Bjurlin MA. Systematic review of smoking relapse rates among cancer survivors who quit at the time of cancer diagnosis. Cancer Epidemiol 2022; 80:102237. [PMID: 35988307 PMCID: PMC10363369 DOI: 10.1016/j.canep.2022.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/30/2022] [Accepted: 08/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Tobacco cessation, at the time of cancer diagnosis, has been associated with better oncologic outcomes. Cancer diagnosis has been shown to serves as a "teachable moment," inspiring tobacco cessation. However, the sustainability of abstinence from smoking is understudied. Similarly, there is a paucity of data regarding the utility of behavioral/pharmacologic intervention to support continued smoking cessation. METHODS A systematic literature review was conducted in August 2021 with no date limits. Relevant studies that reported tobacco smoking relapse rates for patients who quit at the time of cancer diagnosis were included. Our literature search identified 1620 articles and 29 met inclusion criteria. The primary endpoint of the study was smoking relapse rate. Secondary outcome was a descriptive assessment of behavioral and pharmacologic interventions to promote continued cessation. Exploratory outcomes included a regression analysis to examine associations between study factors and relapse rates. RESULTS There were 3021 smokers who quit at the time of cancer diagnosis. Weighted overall relapse rate for the study population was 44 % (range 5-57 %). Interventions to support smoking cessation were employed in 17 of the 29 included studies and protocols were heterogenous, including behavioral, pharmacologic, or mixed intervention strategies. Exploratory analysis demonstrated no association between relapse rates and publication year, gender, or study type. Relapse rates were indirectly associated with age (p = .003), suggesting that younger patients were more likely to relapse. CONCLUSION The sustainability of smoking cessation after a cancer diagnosis is understudied, and existing literature is difficult to interpret due to heterogeneity. Relapse rates remain significant and, although many studies have included the employment of an intervention to promote continued cessation, few studies have measured the effect of a protocolized intervention to support abstinence.
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Affiliation(s)
- Zachary Feuer
- Department of Urology, NYU Langone Health, New York, NY, United States
| | - Jamie Michael
- School of Medicine, University of North Carolina at Chapel Hill, NC, United States
| | - Elizabeth Morton
- Health Sciences Library, University of North Carolina at Chapel Hill, NC, United States
| | - Richard S Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, United States
| | - Kimberly Shoenbill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, United States; Department of Family Medicine, University of North Carolina at Chapel Hill, NC, United States; Program on Health and Clinical Informatics, University of North Carolina at Chapel Hill, NC, United States
| | - Adam Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, United States; Department of Family Medicine, University of North Carolina at Chapel Hill, NC, United States
| | - Scott Sherman
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, United States
| | - Marc A Bjurlin
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, NC, United States; Department of Urology, University of North Carolina at Chapel Hill, NC, United States.
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Jeganathan V, Knight S, Bricknell M, Ridgers A, Wong R, Brazzale DJ, Ruehland WR, Rahman MA, Leong TL, McDonald CF. Impact of smoking status and chronic obstructive pulmonary disease on pulmonary complications post lung cancer surgery. PLoS One 2022; 17:e0266052. [PMID: 35349598 PMCID: PMC8963579 DOI: 10.1371/journal.pone.0266052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/11/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Smoking and chronic obstructive pulmonary disease (COPD) are associated with an increased risk of post-operative pulmonary complications (PPCs) following lung cancer resection. It remains unclear whether smoking cessation reduces this risk. Methods Retrospective review of a large, prospectively collected database of over 1000 consecutive resections for lung cancer in a quaternary lung cancer centre over a 23-year period. Results One thousand and thirteen patients underwent curative-intent lobectomy or pneumonectomy between 1995 and 2018. Three hundred and sixty-two patients (36%) were ex-smokers, 314 (31%) were current smokers and 111 (11%) were never smokers. A pre-operative diagnosis of COPD was present in 57% of current smokers, 57% of ex-smokers and 20% of never smokers. Just over 25% of patients experienced a PPC. PPCs were more frequent in current smokers compared to never smokers (27% vs 17%, p = 0.036), however, no difference was seen between current and ex-smokers (p = 0.412) or between never and ex-smokers (p = 0.113). Those with a diagnosis of COPD, independent of smoking status, had a higher frequency of both PPCs (65% vs 35%, p<0.01) and overall complications (60% vs 40%, p<0.01) as well as a longer length of hospital stay (10 vs 9 days, p<0.01). Conclusion Smoking and COPD are both associated with a higher rate of PPCs post lung cancer resection. COPD, independent of smoking status, is also associated with an increased overall post-operative complication rate and length of hospital stay. An emphasis on COPD treatment optimisation, rather than smoking cessation in isolation, may help improve post-operative outcomes.
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Affiliation(s)
- Vishnu Jeganathan
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- * E-mail:
| | - Simon Knight
- Department of Thoracic Surgery, Austin Health, Heidelberg, Victoria, Australia
| | - Matthew Bricknell
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Anna Ridgers
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Raymond Wong
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Danny J. Brazzale
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Warren R. Ruehland
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Muhammad Aziz Rahman
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Tracy L. Leong
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Christine F. McDonald
- Department of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
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Feasibility of Patient Navigation-Based Smoking Cessation Program in Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074034. [PMID: 35409717 PMCID: PMC8998497 DOI: 10.3390/ijerph19074034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 03/26/2022] [Indexed: 12/04/2022]
Abstract
Continued smoking after a cancer diagnosis is causally associated with increased risks of all-cause and cancer-specific mortality, and of smoking-related second primary cancers. Patient navigation provides individualized assistance to address barriers to smoking cessation treatment and represents a promising bridge to smoking cessation in persons with cancer who smoke cigarettes. We conducted a single-arm interventional cohort study of current smokers identified through prospective health record screening and recruited from Penn State Cancer Institute outpatient clinics. Consented participants received two telephone intervention sessions and gain-framed messaging-based smoking cessation educational materials designed for persons with cancer. The primary study outcome was the feasibility of the patient navigation-based intervention; the secondary outcome was the engagement in smoking cessation treatment at the two-month follow-up. Of 1168 unique screened Cancer Institute patients, 134 (11.5%) were identified as current cigarette smokers. Among 67 patients approached at outpatient clinics, 24 (35.8%) were interested in participating, 12 (17.9%) were enrolled, eight (11.9%) completed the intervention sessions and study assessments, and six engaged in smoking cessation treatment. The participants expressed satisfaction with the intervention sessions (median = 8.5, scale 0–10). The low recruitment rates preclude patient navigation as a feasible method for connecting cancer patients to smoking cessation treatment resources.
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Bayley EM, Zhou N, Mitchell KG, Antonoff MB, Mehran RJ, Rice DC, Sepesi B, Swisher SG, Vaporciyan AA, Walsh GL, Cinciripini PM, Karam-Hage M, Roth JA, Hofstetter WL. Modern Perioperative Practices May Mitigate Effects of Continued Smoking Among Lung Cancer Patients. Ann Thorac Surg 2021; 114:286-292. [PMID: 34358522 DOI: 10.1016/j.athoracsur.2021.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/15/2021] [Accepted: 06/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Though smokers are at an increased risk for postoperative pulmonary complications following thoracic surgery, the relationship between cessation timing and postoperative pulmonary complications has not been explored in an era of enhanced recovery protocols and active tobacco cessation programs. Because a strong preference exists among thoracic surgeons to delay surgery to continued smokers, we sought to evaluate this relationship in a modern era. METHODS Patients undergoing lung resection for a diagnosis of non-small cell lung cancer from 2012-2017 were identified. Multivariable logistic regression was used to evaluate preoperative tobacco cessation timing to determine the impact upon postoperative pulmonary complications. RESULTS 1038 ever-smokers were identified. Patients were current smokers in 30 (3%) instances, and among former smokers, the preoperative cessation interval was 0-14 days in 10% (104), >14 days-1 month in 6% (62), >1 month-1 year in 18% (189), >1-5 years in 10% (107), and >5 years in 53% (546). Pulmonary complications were experienced by 269 (26%) patients. Multivariable analysis revealed that no group of recent or long-term quitters experienced superior outcomes in terms of pulmonary complications, when evaluating various periods of abstinence in comparison to continued smokers and active quitters. CONCLUSIONS In an era of enhanced recovery protocols, minimally invasive surgery, and active tobacco cessation programs which may help patients to cut back, our data do not support the practice of delaying or denying surgery to patients who have difficulty quitting completely. Perioperative cessation counseling should be aimed at long-term benefits, including reduction of disease recurrence and secondary malignancies.
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Affiliation(s)
- Erin M Bayley
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nicolas Zhou
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kyle G Mitchell
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reza J Mehran
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David C Rice
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Boris Sepesi
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen G Swisher
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ara A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Garrett L Walsh
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paul M Cinciripini
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Maher Karam-Hage
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jack A Roth
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wayne L Hofstetter
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
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Howard R, Albright J, Osborne N, Englesbe M, Goodney P, Henke P. Impact of a regional smoking cessation intervention for vascular surgery patients. J Vasc Surg 2021; 75:262-269. [PMID: 34298118 DOI: 10.1016/j.jvs.2021.07.103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Tobacco use is common among vascular surgery patients and negatively impacts outcomes and longevity. In the second quarter of 2018, a statewide vascular quality collaborative launched an initiative across its 35 participating hospitals to promote smoking cessation at the time of surgery. This intervention was based on the Vascular Physician Offer and Report (VAPOR) trial and consisted of 3 components: brief physician-delivered advice, referral to telephone-based counseling, and nicotine replacement therapy. The goal of this study is to evaluate the results of this intervention. METHODS We performed a retrospective analysis of patients undergoing vascular surgery between 2018 and 2020. Procedures included open abdominal aortic aneurysm repair, endovascular aneurysm repair, open vascular bypass, open thrombectomy, carotid endarterectomy, and carotid stenting. The primary explanatory variables were receipt of tobacco cessation interventions as documented in the medical record. The primary outcome was tobacco cessation, captured during 30-day and 1-year chart review and/or patient follow-up. A multivariable logistic regression model was calculated to estimate the association of covariates with smoking cessation while adjusting for patient and clinical characteristics. RESULTS A total of 13,890 patients underwent surgery during the study period. The mean age was 69.4 ± 10 years; 4687 patients (34%) were female, and 5158 patients (37%) were current smokers. At least one smoking cessation component was delivered to 2245 patients (44% of smokers). The quit rate was 35% among 4671 patients with 30-day follow-up and 43% among 2936 patients with 1-year follow up. On multivariable regression, at 30 days, receiving two intervention components was associated with 1.29 (95% confidence interval [CI], 1.07-1.55) higher odds of quitting. At both time points, smoking cessation was also associated with undergoing an emergent procedure (30-day odds ratio [OR], 1.52; 95% CI, 1.16-1.99; 1-year OR, 1.41; 95% CI, 1.01-1.97) and undergoing open abdominal aortic aneurysm repair (30-day OR, 1.71; 95% CI, 1.20-2.43; 1-year OR, 1.75; 95% CI, 1.11-2.78). CONCLUSIONS In a cohort of vascular surgical patients where tobacco use was common, nearly one-half of patients quit smoking 1 year after surgery. Receiving two smoking cessation intervention components was associated with quitting at 30 days. Overall, these results demonstrate encouraging quit rates and identify an opportunity for longer-term intervention to maintain even greater 1-year tobacco cessation.
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Affiliation(s)
- Ryan Howard
- Department of Surgery, University of Michigan, Ann Arbor, Mich
| | - Jeremy Albright
- Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Mich
| | - Nicholas Osborne
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich
| | | | - Philip Goodney
- Section of Vascular Surgery and the Dartmouth Institute, Dartmouth-Hitchcock Medical Center, Dartmouth, Lebanon, NH
| | - Peter Henke
- Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.
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Rajapakse P. An Update on Survivorship Issues in Lung Cancer Patients. World J Oncol 2021; 12:45-49. [PMID: 34046098 PMCID: PMC8139739 DOI: 10.14740/wjon1368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
Recent advances in lung cancer therapeutics and screening have led to increased numbers of lung cancer survivors. Most survivors have undergone invasive treatment (surgery, radiation therapy, chemotherapy and/or immunotherapy) and carry a high comorbidity burden. Overall quality of life suffers during the evaluation, treatment and follow-up phase, with the potential for long-term decline. The issues faced by survivors include physical symptoms, emotional distress as well as socioeconomic instability. These issues may lead to poor compliance with recommended follow-up plan. This article provides an up-to-date literature review on the major issues faced by lung cancer survivors and identifies under-recognized problems such as stigma, financial toxicity and sexual dysfunction. Future collaborative efforts are needed to further elucidate the complex issues that affect overall well-being of lung cancer survivors and to develop appropriate interventions in this expanding survivor population.
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Affiliation(s)
- Pramuditha Rajapakse
- Department of Internal Medicine and Hematology/ Oncology, Danbury Hospital, Nuvance Health, 24, Hospital Ave., Danbury, CT 06810, USA.
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Yang CC, Liu CY, Wang KY, Chang YK, Wen FH, Lee YC, Chen ML. Trajectory of smoking behaviour during the first 6 months after diagnosis of lung cancer: A study from Taiwan. J Adv Nurs 2021; 77:2363-2373. [PMID: 33547835 DOI: 10.1111/jan.14745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/02/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
AIMS To identify different classes of change pattern/ trajectory of tobacco smoking behaviour after diagnosis of lung cancer using multi-wave data and to explore factors associated with the class membership. DESIGN This is a multi-wave observational study. METHODS Smoking behaviour data were collected at diagnosis and then every month for 6 months from 133 newly diagnosed people with lung cancer who had recently quit smoking or continued to smoke at diagnosis. These patients were recruited from three medical centres and data were collected from May 2014 to January 2017. Smoking behaviour was assessed based on patients' self-reports on whether they smoked during the last month (yes/no) for a total of seven times. Mixture latent Markov model and logistic regression were used to analyse data. RESULTS Two latent classes of smoking trajectory were identified among recent quitters or current smokers of people with lung cancer, namely "perseverance for abstinence" and "indecisive for abstinence." Patients who were younger age (OR = 0.95, p = 0.026), exposure to second-hand smoke (OR = 3.35, p = 0.012) and lower self-efficacy for not smoking (OR = 0.96, p = 0.011) were more likely to belong to the class of "indecisive for abstinence." CONCLUSIONS Heterogeneous classes of smoking trajectory existed in newly diagnosed people with lung cancer. The risk factors associated with a less favourable smoking trajectory can be incorporated into tailored smoking-cessation programs for patients newly diagnosed with lung cancer. IMPACT The dynamic trajectory of smoking behaviour had not been adequately explored among newly diagnosed people with lung cancer. Two classes of smoking trajectory and the predictors associated with the class membership were identified. These findings suggest that the diagnosis of cancer is a teachable moment for smoking cessation. Patients with younger age, lower self-efficacy of not smoking and exposure to second-hand smoke at home need special attention.
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Affiliation(s)
- Chia-Chen Yang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Ying Liu
- Lung Tumor and Endoscopy, Department of Thoracic Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kwua-Yun Wang
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Yun-Kuang Chang
- Department of Nursing, Fu Jen Catholic University Hospital, New Taipei City, Taiwan
| | - Fur-Hsing Wen
- Department of International Business, School of Business, Soochow University, Taipei, Taiwan
| | - Yu-Chin Lee
- Department of Respiratory Therapy & Chest Medicine, Sijhih Cathay General Hospital, New Taipei, Taiwan
| | - Mei-Ling Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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13
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Jensen BT, Lauridsen SV, Scheede-Bergdahl C. The Potential of Prehabilitation in Radical Cystectomy Pathways: Where Are We Now? Semin Oncol Nurs 2021; 37:151107. [PMID: 33446382 DOI: 10.1016/j.soncn.2020.151107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The growing recognition of prehabilitation has caused an emerging paradigm shift in surgical cancer care and an integrated component of the cancer care continuum. This narrative review aims to update and inform the urological community of the potential of prehabilitation before radical cystectomy. DATA SOURCES A nonsystematic narrative review was performed through a database search in PubMed, and CINAHL using the following search terms: enhanced recovery after surgery (ERAS); Frailty; Prehabilitation and/or Rehabilitation; Physical Activity and/or exercises; Nutrition; Nutritional Care; Smoking cessation; Alcohol cessation; Prevention; Supportive Care; and combined with Radical Cystectomy. CONCLUSION A multimodal and multi-professional approach during the preoperative period may offer an opportunity to preserve or enhance physiological integrity and optimize surgical recovery. Studies indicate a positive effect of prehabilitation on postoperative functional capacity and earlier return to daily activities and health related quality of life. Meaningful outcomes that reflect recovery from a patient's perspective and clinical outcome measures, as well as validating metrics, are necessary to establish whether prehabilitation diminish the risk of developing long-term disability in high-risk patients. IMPLICATIONS FOR NURSING PRACTICE Uro-oncology nurses are at the forefront in every ERAS program and vital in screening patients ahead of surgery for common risk factors, current impairments, and limitations that can compromise baseline functional capacity. The growing movement to standardize clinical implementation of prehabilitation, indicate there is a clear need for further investigation, optimization of a multimodal approach and an open discussion between health care providers from different areas of expertise who might best support and promote these initiatives.
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Affiliation(s)
| | - Susanne Vahr Lauridsen
- Department of Urology, Copenhagen University Hospital, Denmark and WHO-CC, Parker Institute Bispebjerg & Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Celena Scheede-Bergdahl
- Department of Kinesiology and Physical Education, Department of Anesthesiology, McGill University, Montreal, Quebec, Canada
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14
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Brett J, Davies EL, Matley F, Aveyard P, Wells M, Foxcroft D, Nicholson B, De Silva Minor S, Sinclair L, Jakes S, Watson E. Electronic cigarettes as a smoking cessation aid for patients with cancer: beliefs and behaviours of clinicians in the UK. BMJ Open 2020; 10:e037637. [PMID: 33444179 PMCID: PMC7678366 DOI: 10.1136/bmjopen-2020-037637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/04/2020] [Accepted: 10/30/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To explore UK clinicians' beliefs and behaviours around recommending e-cigarettes as a smoking cessation aid for patients with cancer. DESIGN Cross-sectional online survey. SETTING England, Wales, Scotland and Northern Ireland. PARTICIPANTS Clinicians involved in the care of patients with cancer. PRIMARY AND SECONDARY OUTCOMES Behavioural Change Wheel capability, opportunity and motivation to perform a behaviour, knowledge, beliefs, current practice around e-cigarettes and other smoking cessation practices. METHOD Clinicians (n=506) completed an online survey to assess beliefs and behaviours around e-cigarettes and other smoking cessation practices for patients with cancer. Behavioural factors associated with recommending e-cigarettes in practice were assessed. RESULTS 29% of clinicians would not recommend e-cigarettes to patients with cancer who continue to smoke. Factors associated with recommendation include smoking cessation knowledge (OR 1.56, 95% CI 1.01 to 2.44) and e-cigarette knowledge (OR 1.64, 95% CI 1.06 to 2.55), engagement with patients regarding smoking cessation (OR 2.12, 95% CI 1.12 to 4.03), belief in the effectiveness of e-cigarettes (OR 2.36 95% CI 1.61 to 3.47) and belief in sufficient evidence on e-cigarettes (OR 2.08 95% CI 1.10 to 4.00) and how comfortable they felt discussing e-cigarettes with patients (OR 1.57 95% CI 1.04 to 2.36). CONCLUSION Many clinicians providing cancer care to patients who smoke do not recommend e-cigarettes as a smoking cessation aid and were unaware of national guidance supporting recommendation of e-cigarettes as a smoking cessation aid.
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Affiliation(s)
- Jo Brett
- Health & Life Sciences, Oxford Brookes University, Oxford, UK
| | - Emma L Davies
- Department of Psychology, Social Workand Public Health Oxford Brookes University, Oxford, UK
| | - Fiona Matley
- Health & Life Sciences, Oxford Brookes University, Oxford, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mary Wells
- Department of Surgery & Cancer, Faculty of Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - David Foxcroft
- Department of Psychology, Social Workand Public Health Oxford Brookes University, Oxford, UK
| | - Brian Nicholson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Lesley Sinclair
- Molecular, Genetic and Population Health Sciences, University of Edinburgh, Edinburgh, Scotland
| | | | - Eila Watson
- Health & Life Sciences, Oxford Brookes University, Oxford, UK
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15
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Mathew B, Vidhubala E, Krishnamurthy A, Sundaramoorthy C. Can Cancer Diagnosis Help in Quitting Tobacco? Barriers and Enablers to Tobacco Cessation Among Head and Neck Cancer Patients from a Tertiary Cancer Center in South india. Indian J Psychol Med 2020; 42:346-352. [PMID: 33402796 PMCID: PMC7746891 DOI: 10.1177/0253717620930317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Tobacco use contributes to almost 40% of the cancers in India. Considering the potential threat, many preventive measures have been instigated in the country. However, tobacco cessation for hospitalized cancer patients is an unexplored territory in India. This study aims to understand the quit status and to explore the reasons to quit or continue the use of tobacco after the diagnosis of head and neck cancer (HNC). METHODS HNC patients admitted between February and April 2016 were assessed for their tobacco use status. A DT was used to assess the psychological distress. Users were assessed for their readiness to quit and dependence on tobacco. An in-depth interview was conducted among 25 patients (seven current users and 18 recent quitters), and themes that emerged were discussed. RESULTS Of the 119 HNC patients, 71 were tobacco users and 48 had quit tobacco after the diagnosis. The reasons to quit were the perceived benefits of quitting, advice from the physicians, and awareness about cancer and its association with tobacco. In contrast, the reasons to continue the use of tobacco were attributed to coping mechanisms, nihilistic perception about the outcome of the cancer, and a lack of understanding about cancer and its association with tobacco. CONCLUSION The recent quitters comprehended the benefits of quitting and were able to prioritize their needs after the diagnosis. However, one-third of the HNC patients continued to use tobacco even after the diagnosis of cancer. Hence, tobacco cessation services need to be integrated into oncology services for achieving better treatment outcomes.
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Affiliation(s)
- Bincy Mathew
- Dept. of Psycho-oncology, Cancer
Institute (WIA), Chennai, Tamil Nadu, India
| | - E. Vidhubala
- Dept. of Psycho-oncology, Cancer
Institute (WIA), Chennai, Tamil Nadu, India
| | | | - C. Sundaramoorthy
- Dept. of Psycho-oncology, Cancer
Institute (WIA), Chennai, Tamil Nadu, India
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16
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Design and Pilot Implementation of an Electronic Health Record-Based System to Automatically Refer Cancer Patients to Tobacco Use Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114054. [PMID: 32517176 PMCID: PMC7312526 DOI: 10.3390/ijerph17114054] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Abstract
Continued tobacco use after cancer diagnosis is detrimental to treatment and survivorship. The current reach of evidence-based tobacco treatments in cancer patients is low. As a part of the National Cancer Institute Cancer Center Cessation Initiative, the Mayo Clinic Cancer Center designed an electronic health record (EHR, Epic©)-based process to automatically refer ambulatory oncology patients to tobacco use treatment, regardless of intent to cease tobacco use(“opt out”). The referral and patient scheduling, accomplished through a best practice advisory (BPA) directed to staff who room patients, does not require a co-signature from clinicians. This process was piloted for a six-week period starting in July of 2019 at the Division of Medical Oncology, Mayo Clinic, Rochester, MN. All oncology patients who were tobacco users were referred for tobacco treatment by the rooming staff (n = 210). Of these, 150 (71%) had a tobacco treatment appointment scheduled, and 25 (17%) completed their appointment. We conclude that an EHR-based “opt-out” approach to refer patients to tobacco dependence treatment that does not require active involvement by clinicians is feasible within the oncology clinical practice. Further work is needed to increase the proportion of scheduled patients who attend their appointments.
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17
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Continued smoking after a cancer diagnosis: a longitudinal study of intentions and attempts to quit. J Cancer Surviv 2019; 13:687-694. [PMID: 31332721 DOI: 10.1007/s11764-019-00787-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Continued smoking after a cancer diagnosis is associated with poor treatment outcomes and reduced life expectancy. We aimed to identify the stability of smoking status after diagnosis including quit attempts and quit intentions. METHODS Participants with a first primary cancer diagnosis were recruited via two state-based registries in Australia. Questionnaires were mailed at approximately 6 months (T1), 1 year (T2), 2 years (T3), and 3.5 years (T4) post-diagnosis. Smoking status and quitting intentions were assessed at each time point. RESULTS A cohort of 1444 people was recruited. People who indicated that they were more than 9 months post-diagnosis are excluded from analysis, leaving 1407 eligible study participants. Sixty-six (37%) of the 178 self-reported smokers at diagnosis had quit in the 6-month post-diagnosis (T1), the remaining 112 (63%) reported being a current smoker. Of the smokers at T1, 40% intended to quit: with 8% having quit smoking by T2; 11% quit by T3; 12% quit by T4. Of those who reported at T1 that they intended to quit in the next 6 months, 10% or fewer reported having quit at any subsequent time point. Quitting attempts decreased in frequency over time post-diagnosis. Less than 15% of respondents who had quit at or shortly before diagnosis reported relapse to smoking at each time point. CONCLUSIONS The majority of smokers diagnosed with cancer continue to smoke beyond diagnosis, even in the context of an intention to quit and attempts to do so. Cancer survivors who smoke remain motivated to quit well beyond the initial diagnosis. IMPLICATIONS FOR CANCER SURVIVORS There are clear positive clinical effects of smoking cessation for those who have undergone treatment for cancer, both for short-term treatment outcomes, and for long-term survivorship. Given the substantial rates of continued smoking among those who report smoking at diagnosis and their continued attempts to quit during survivorship, there is a need for improved cessation support initiatives for people diagnosed with cancer. These initiatives need to continue to be offered to smokers long after the initial diagnosis and treatment.
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18
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Nightingale CL, Steffen LE, Tooze JA, Petty W, Danhauer SC, Badr H, Weaver KE. Lung Cancer Patient and Caregiver Health Vulnerabilities and Interest in Health Promotion Interventions: An Exploratory Study. Glob Adv Health Med 2019; 8:2164956119865160. [PMID: 31360617 PMCID: PMC6637827 DOI: 10.1177/2164956119865160] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 06/14/2019] [Accepted: 06/28/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Lung cancer patients and their caregivers are at risk for negative health behaviors and poor psychosocial functioning, but few interventions exist that target this population. To inform intervention development, we explored potential targets and interest and concordance in health promotion interventions among lung cancer patients and their caregivers. Methods Lung cancer patients (n = 18) with a smoking history and their caregivers (n = 15) participated in a cross-sectional, observational survey study (an average of 1 month postdiagnosis) to assess health behaviors, psychosocial functioning, and interest in health promotion interventions. Fisher’s exact and Wilcoxon rank-sum tests examined factors associated with intervention interest. McNemar’s test examined concordance in interest. Results Many caregivers (40%) reported providing care at least 4 days per week, and over half (53.3%) reported a smoking history. Patients reported high cancer self-blame (mean = 3.1, standard deviation = 0.9, range = 1–4). Patients (55.6%) and caregivers (60%) reported clinically significant depressive symptoms. There was high interest and concordance in interest in cancer education (patients, 77.8%; caregivers, 86.7%) and diet and exercise (patients, 66.7%; caregivers, 80%) interventions. Significantly more caregivers were interested in stress reduction (patients, 53.3%; caregivers, 73.3%; P = .05) and yoga (patients, 16.7%; caregivers, 50%; P = .03) than patients. Caregivers interested in stress reduction interventions had higher levels of distress than those not interested. Discussion Health promotion interventions are needed and of interest to lung cancer patients and caregivers. Shared interests in interventions suggest dyadic interventions may be appropriate, yet interventions should also address distinct patient and caregiver needs.
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Affiliation(s)
- Chandylen L Nightingale
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Laurie E Steffen
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Janet A Tooze
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - William Petty
- Section on Hematology and Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Suzanne C Danhauer
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Hoda Badr
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathryn E Weaver
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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19
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Martínez Ú, Brandon KO, Sutton SK, Brandon TH, Simmons VN. Does smoking abstinence predict cancer patients' quality of life over time? Psychooncology 2019; 28:1702-1711. [PMID: 31212391 DOI: 10.1002/pon.5145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/30/2019] [Accepted: 06/06/2019] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Smoking cessation improves quality of life (QOL) in the general population. However, there is limited information on the role of smoking status on QOL among cancer patients. Moreover, previous studies tended to analyze smoking status dichotomously and at a single point in time, potentially reducing the strength of the relation between smoking cessation and QOL. This study examined the association of smoking abstinence and QOL over time, including depression, pain, and fatigue in patients with a wide variety of cancers. METHODS Participants were 332 cancer patients (eg, gynecologic, breast, thoracic, head and neck, and genitourinary) who had been abstinent for at least 24 hours. Days abstinent and QOL were assessed at baseline and 2, 6, and 12 months later. Latent growth curve models examined if days abstinent was associated with QOL at each assessment. Baseline demographics (eg, sex and income) and smoking history variables (eg, nicotine dependence) were used as time-invariant covariates. RESULTS The final model for each QOL component had good-to-excellent fit. More days abstinent was associated with lower depression at all follow-ups and with lower fatigue at 12 months but was not associated with pain. CONCLUSIONS QOL was better among patients who quit smoking for longer periods. Findings suggest different timelines, with smoking abstinence most immediately associated with lower depression, followed by lower fatigue. Although pain decreased over time, it was not associated with length of smoking abstinence. Results reinforce the relationship between sustained smoking cessation and QOL, which should be communicated to patients.
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Affiliation(s)
- Úrsula Martínez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Steven K Sutton
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, Florida.,Department of Psychology, University of South Florida, Tampa, Florida.,Department of Oncologic Sciences, University of South Florida, Tampa, Florida
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20
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Abstract
Tobacco smoking accounts for at least 30% of all cancer deaths and nearly 90% of lung cancer deaths. Smoking cessation significantly reduces the risk of developing tobacco-related malignancies. Smoking after cancer diagnosis is also associated with multiple risks, including worse tolerance of treatment, higher risk of a failure and second primary tumors, and poorer quality of life. Apart from disease site and stage, continued smoking is considered the strongest adverse predictor of survival in cancer patients. However, the benefits of smoking cessation are undervalued: many patients are not aware of harms related to continued tobacco use after cancer diagnosis. Furthermore, health care professionals often do not encourage their patients to quit, and do not provide tobacco cessation assistance for continuing tobacco users. Despite the apparent impact of tobacco use on treatment outcomes, data on current smoking status is only rarely captured in clinical trials This article reviews the most important clinical aspects of smoking after the diagnosis of cancer.
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Affiliation(s)
- Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
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21
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F. Carreno D, Pérez-Escobar JA. Addiction in existential positive psychology (EPP, PP2.0): from a critique of the brain disease model towards a meaning-centered approach. COUNSELLING PSYCHOLOGY QUARTERLY 2019. [DOI: 10.1080/09515070.2019.1604494] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - José Antonio Pérez-Escobar
- Chair of History and Philosophy of Mathematics, Department of Humanities, Social and Political Sciences, ETH Zürich, Zurich, Switzerland
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22
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Cooley ME, Poghosyan H, Sprunck-Harrild K, Winickoff JP, Edge SB, Emmons KM. Tobacco treatment implementation within 28 commission on cancer accredited programs in the Northeast region of the USA: A pilot study. Transl Behav Med 2019. [PMID: 29528457 DOI: 10.1093/tbm/ibx024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cancer survivors are a rapidly growing population and an important target for tobacco treatment interventions. Continued smoking after the diagnosis of cancer is associated with a higher risk of cancer recurrence and mortality. Systematic tobacco cessation programs are effective. This study surveyed American College of Surgeons Commission on Cancer (CoC) programs in the Northeast region of the USA regarding their tobacco control programs. Seventy percent of cancer survivors are treated within CoC programs. The purpose of this study was to describe the extent of implementation of tobacco treatment and determine the organizational delivery of tobacco treatment as measured by the presence of goals to address smoking, leadership support, and integration of tobacco treatment guidelines into care delivery. Data were collected by a survey. The Assessment of Chronic Illness Care questionnaire was used to collect data on implementation of tobacco treatment services. Descriptive statistics were used to analyze the data. Most programs (78.6%) had an electronic health record and of these 68% captured smoking status. Implementation of tobacco treatment was not optimal for identifying smokers, providing patients with community linkages or self-care cessation support. Implementation of decision aides for pharmacotherapy and reassessment of smoking status were the least developed areas. Moreover, the organizational delivery for tobacco treatment was less than optimal. Many cancer programs have not implemented systems to deliver optimal tobacco treatment. Efforts should be made to help cancer programs develop sustainable system-wide programs that address the urgent need to deliver tobacco treatment to all cancer survivors.
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Affiliation(s)
| | | | | | | | - Stephen B Edge
- American College of Surgeons Commission on Cancer, Chicago, IL, USA.,Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Karen M Emmons
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
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23
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Lee K, Oh EG, Kim S, Kim S. Symptom experiences and health‐related quality of life among non‐small cell lung cancer patients participating in clinical trials. J Clin Nurs 2019; 28:2111-2123. [DOI: 10.1111/jocn.14803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Kyunghwa Lee
- Department of Nursing Yonsei University Graduate School Seoul Korea
| | - Eui Geum Oh
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sanghee Kim
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sang‐We Kim
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine Seoul Korea
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24
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Gu F, Li XF, Xu JF, Gao GH, Wu YF, Zhou CC. Effect of nicotine dependence on quality of life and sleep quality in patients with lung cancer who continue to smoke after diagnosis. J Thorac Dis 2018; 10:2583-2589. [PMID: 29997919 DOI: 10.21037/jtd.2018.05.12] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Hundreds of millions of Chinese individuals continue to smoke and rates of lung cancer still continue to rise. However, there were few studies that examined the effects of nicotine dependence on quality of life (QOL) and sleep quality in lung cancer patients. This study aimed to investigate the effect of nicotine dependence on QOL and sleep quality in lung cancer patients who continue to smoke after diagnosis. Methods This cross-sectional survey study included 202 patients with lung cancer. Smokers were separated into two groups based on the Fagerstrom Test for Nicotine dependence: the low dependence (LD) (<4 score) group (n=59) and the high dependence (HD) (≥4 score) group (n=143). Both Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) and Chinese version of Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the two groups of lung cancer patients. Then we analyzed the difference of QOL and sleep quality between two distinct nicotine dependence groups. Results Physical functioning, role functioning, emotional functioning, cognitive functioning, global health status and social functioning items in the LD group were significantly higher than the HD group (P<0.001). Fatigue, nausea/vomiting, pain, dyspnea, insomnia, appetite loss, diarrhea and financial problems in the LD group were significantly lower than those in the HD group (P<0.001). Significantly higher scores in the HD group were found concerning the three sleep components including sleep duration, sleep efficiency and daytime function. The mean global PSQI score in the HD group was significantly higher than the LD group (P=0.014). Conclusions These findings suggest that lung cancer patients who continue to smoke after diagnosis should receive health education in order to improve their QOL and quality of sleep after the word education. This can be useful for clinicians and nurses who are trying to motivate smokers to quit smoking.
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Affiliation(s)
- Fen Gu
- Oncology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Xue-Fei Li
- Oncology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Jin-Fu Xu
- Respiratory Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Guang-Hui Gao
- Oncology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Yi-Fan Wu
- Oncology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
| | - Cai-Cun Zhou
- Oncology Department, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
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25
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Sampson L, Papadakos J, Milne V, Le LW, Liu G, Abdelmutti N, Milne R, Goldstein DP, Eng L, Giuliani M. Preferences for the Provision of Smoking Cessation Education Among Cancer Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:7-11. [PMID: 27075196 DOI: 10.1007/s13187-016-1035-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Many individuals who use tobacco will continue to smoke after a cancer diagnosis and throughout treatment. This study aims to better understand cancer patient preferences to learn about smoking cessation. All new patients seen at Princess Margaret Cancer Centre between 1 January 2014 and 30 June 2015 were asked to complete the Combined Tobacco History Survey as part of standard new patient assessments. Smoking status, second hand smoke exposure, years smoked, family support, cessation preferences, demographic and tumour details were collected. Multivariable regression assessed factors associated with smoking cessation educational preferences. Nine thousand and one hundred ten patients completed the survey. One thousand and six hundred ninety-one were current smokers (17 %) of which 43 % were female and median age was 57 years (range 18-95). One thousand and two hundred thirty-eight (73 %) were willing to consider quitting and 953 (56 %) reported a readiness to quit next month. Patients were most interested in pamphlets (45 %) followed by telephone support (39 %), speaking with a healthcare professional (29 %), website (15 %), support group (11 %) and speaking with successful former smokers (9 %). Younger patients (≤45 years) preferred receiving smoking cessation education over the telephone (50 %; p < 0.001), while older patients (46-65 years and >65 years) preferred smoking education to be provided in pamphlets (43 and 51 %, respectively; p = 0.07). In multivariable analyses, older patients were more likely to prefer pamphlets than younger patients OR 1.11 (95 % CI 1.01-1.23; p = 0.03). Older cancer patients preferred to receive smoking cessation education through pamphlets and younger patients preferred the telephone. Tailored provision of cessation education resources for cancer patients is warranted.
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Affiliation(s)
- Lorna Sampson
- Department of Radiation Oncology, Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada
| | - Janet Papadakos
- Patient & Survivorship Education, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Victoria Milne
- Department of Radiation Oncology, Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada
| | - Lisa W Le
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Geoffrey Liu
- Division of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Nazek Abdelmutti
- Health Promotion and Wellness, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Robin Milne
- Department of Radiation Oncology, Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada
| | - David P Goldstein
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lawson Eng
- Department of Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - Meredith Giuliani
- Department of Radiation Oncology, Princess Margaret Cancer Centre, 610 University Ave, Toronto, Ontario, M5G 2M9, Canada.
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Webb LA, McDonnell KK. Not a Death Sentence: Perspectives of African American Women Living With Lung Cancer
. Oncol Nurs Forum 2018; 45:46-54. [PMID: 29251297 DOI: 10.1188/18.onf.46-54] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To conduct a descriptive, qualitative study to describe the experience of female African American lung cancer survivors, their perception of living with lung cancer, and their desire and ability to adopt positive health-related behaviors.
. PARTICIPANTS & SETTING The sample consisted of 18 African American women with a history of stages I-IIIa lung cancer. Three focus groups were conducted in a private conference center in two community hospitals in the southeastern United States.
. METHODOLOGIC APPROACH A 20-item questionnaire was used to collect demographic, health status, and behavior information. A trained moderator led the audio-recorded focus group discussions using a semistructured interview guide.
. FINDINGS Thematic analysis of the professionally transcribed data resulted in identification of four major themes. In addition, participants experienced stigma that influenced their perspectives on living with lung cancer.
. IMPLICATIONS FOR NURSING Healthcare professionals should provide culturally tailored communication and support for female African American lung cancer survivors. Additional research is needed to inform the development of interventions focused on health behavior change to enhance lung cancer survivorship in this vulnerable and understudied group.
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Koshiaris C, Aveyard P, Oke J, Ryan R, Szatkowski L, Stevens R, Farley A. Smoking cessation and survival in lung, upper aero-digestive tract and bladder cancer: cohort study. Br J Cancer 2017; 117:1224-1232. [PMID: 28898236 PMCID: PMC5674091 DOI: 10.1038/bjc.2017.179] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/26/2017] [Accepted: 05/26/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The aim was to examine the association between smoking cessation and prognosis in smoking-related cancer as it is unclear that cessation reduces mortality. METHODS In this retrospective cohort study from 1999 to 2013, we assessed the association between cessation during the first year after diagnosis and all-cause and cancer-specific mortality. RESULTS Of 2882 lung, 757 upper aero-digestive tract (UAT) and 1733 bladder cancer patients 27%, 29% and 21% of lung, UAT and bladder cancer patients quit smoking. In lung cancer patients that quit, all-cause mortality was significantly lower (HR: 0.82 (0.74-0.92), while cancer-specific mortality (HR: 0.89 (0.76-1.04) and death due to index cancer (HR: 0.90 (0.77-1.05) were non-significantly lower. In UAT cancer, all-cause mortality (HR: 0.81 (0.58-1.14), cancer-specific mortality (HR: 0.84 (0.48-1.45), and death due to index cancer (HR: 0.75 (0.42-1.34) were non-significantly lower. There was no evidence of an association between quitting and mortality in bladder cancer. The HRs were 1.02 (0.81-1.30) for all-cause, 1.23 (0.81-1.86) for cancer specific, and 1.25 (0.71-2.20) for death due to index cancer. These showed a non-significantly lower risk in sensitivity analyses. CONCLUSIONS People with lung and possibly UAT cancer who quit smoking have a lower risk of mortality than people who continue smoking.
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Affiliation(s)
- C Koshiaris
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - P Aveyard
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - J Oke
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - R Ryan
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - L Szatkowski
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, Nottingham City Hospital, Nottingham NG5 1PB, UK
| | - R Stevens
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - A Farley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Farley A, Koshiaris C, Oke J, Ryan R, Szatkowski L, Stevens R, Aveyard P. Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Upper Aerodigestive Tract Cancer. Ann Fam Med 2017; 15:443-450. [PMID: 28893814 PMCID: PMC5593727 DOI: 10.1370/afm.2100] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/27/2017] [Accepted: 02/19/2017] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Smoking cessation after a diagnosis of lung, bladder, and upper aerodigestive tract cancer appears to improve survival, and support to quit would improve cessation. The aims of this study were to assess how often general practitioners provide active smoking cessation support for these patients and whether physician behavior is influenced by incentive payments. METHODS Using electronic primary care records from the UK Clinical Practice Research Datalink, 12,393 patients with incident cases of cancer diagnosed between 1999 and 2013 were matched 1 to 1 to patients with incident cases of coronary heart disease (CHD) diagnosed during the same time. We assessed differences in the proportion for whom physicians updated smoking status, advised quitting, and prescribed cessation medications, as well as the proportion of patients who stopped smoking within a year of diagnosis. We further examined whether any differences arose because the physicians were offered incentives to address smoking in patients with CHD and not cancer. RESULTS At diagnosis, 32.0% of patients with cancer and 18.2% of patients with CHD smoked tobacco. Patients with cancer were less likely than patients with CHD to have their general practitioners update smoking status (OR = 0.18; 95% CI, 0.17-0.19), advise quitting (OR = 0.38; 95% CI, 0.36-0.40), or prescribe medication (OR = 0.67; 95% CI, 0.63-0.73), and they were less likely to have stopped smoking (OR = 0.76; 95% CI, 0.69-0.84). One year later 61.7% of patients with cancer and 55.4% with CHD who were smoking at diagnosis were still smoking. Introducing incentive payments was associated with more frequent interventions, but not for patients with CHD specifically. CONCLUSIONS General practitioners were less likely to support smoking cessation in patients with cancer than with CHD, and patients with cancer were less likely to stop smoking. This finding is not due to the difference in incentive payments.
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Affiliation(s)
- Amanda Farley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Constantinos Koshiaris
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Oxford, United Kingdom
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Oxford, United Kingdom
| | - Ronan Ryan
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Lisa Szatkowski
- Division of Epidemiology and Public Health, UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, United Kingdom
| | - Richard Stevens
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Oxford, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, UK Centre for Tobacco and Alcohol Studies, University of Oxford, Oxford, United Kingdom
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Capelletto E, Rapetti SG, Demichelis S, Galetta D, Catino A, Ricci D, Moretti AM, Bria E, Pilotto S, Bruno A, Valmadre G, Bandelli GP, Trisolini R, Gianetta M, Pacchiana MV, Vallone S, Novello S. Final data of an Italian multicentric survey about counseling for smoking cessation in patients with diagnosis of a respiratory disease. CLINICAL RESPIRATORY JOURNAL 2017; 12:1150-1159. [PMID: 28466511 DOI: 10.1111/crj.12644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 04/14/2017] [Accepted: 04/23/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Smoking is the major risk factor for cancer and several respiratory diseases. Quitting smoking at any point of life may increase the effectiveness of treatments and improve prognosis of patients with any pulmonary disease, including lung cancer. However, few institutions in Europe offer to patients adequate counseling for smoking cessation. OBJECTIVES Aim of this study was to investigate the level of counseling for smoking cessation offered by healthcare professionals to patients and their appreciation towards the intervention itself. METHODS Between January 2013 and February 2016, 490 patients, diagnosed with a respiratory diseases, were prospectively evaluated with an anonymous survey developed by WALCE (Women Against Lung Cancer in Europe). RESULTS The majority of patients enrolled (76%) declared to have stopped smoking after the diagnosis of a respiratory disease, 17% to smoke less, 7% to continue smoking. Patients who reported to have never received any counseling for smoking cessation were 38%. Almost 73% of the other patients reported a positive judgment about the quality of healthcare's intervention. Despite these favorable considerations, 83% of patients have disclosed they simply quit smoking overnight without help, 5% have used electronic cigarettes, 5% nicotine replacement treatments, 4% dedicated books, 3% have attended a referral clinic. CONCLUSIONS Considering all the smoking-related side effects, greater efforts should be made in order to better support patients in smoking cessation. Smoking should be considered as a real physical disorder and similar surveys should be encouraged with the aim to fight the 'stigma' of smoking that still exists among patients.
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Affiliation(s)
| | | | | | | | | | - Donata Ricci
- Clinical Cancer Center "Giovanni Paolo II", Bari, Italy
| | | | - Emilio Bria
- Medical Oncology, University of Verona, Verona, Italy
| | - Sara Pilotto
- Medical Oncology, University of Verona, Verona, Italy
| | | | | | - Gian Piero Bandelli
- Department of Oncology, University of Turin, Turin, Italy.,Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Rocco Trisolini
- Interventional Pulmonology Unit, Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | | | | | | | - Silvia Novello
- Department of Oncology, University of Turin, Turin, Italy
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Tobacco Use Disorder Among Patients With Smoking-related Chronic Medical Disease: Association With Comorbid Substance Use Disorders. J Addict Med 2017; 11:293-299. [PMID: 28368906 DOI: 10.1097/adm.0000000000000311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Very little is known of the behavioral vulnerabilities of patients diagnosed with smoking-related chronic medical illness who continue to smoke, potentially worsening morbidity and mortality risks. This study explores the association of tobacco use disorder (TUD) among those with smoking-related chronic medical illnesses with other substance use disorders (SUDs) and risk factors. METHODS Among veterans with smoking-related chronic medical illnesses identified from the National Veterans Health Administration administrative records from fiscal year 2012, we compared the characteristics of those with a diagnosis of TUD (International Classification of Diseases, 9th edition code 305.xx; n = 519,918), and those without such a diagnosis (n = 2,691,840). Using multiple logistic regression, we further explored the independent association of factors associated with TUD. RESULTS SUD prevalence was markedly higher among those with TUD (24.9% vs 5.44%), including alcohol use disorder (20.4% vs 4.3%) and drug use disorder (13.5% vs 2.6%), compared with nonsmokers. On multiple logistic regression analyses, alcohol use disorder (odds ratio [OR] 2.94, 95% confidence interval [CI] 2.90-2.97) and drug use disorder (OR 1.97, 95% CI 1.94-1.99) were independently associated with current TUD diagnosis. Having any single SUD was associated with considerably high odds of having TUD (OR 3.32, 95% CI 3.29-2.36), and having multiple SUDs with even further increased risk (OR 4.09, 95% CI 4.02-4.16). CONCLUSIONS A substantial proportion of people with TUD diagnosis despite concurrent smoking-related medical illnesses are also likely to have other comorbid SUDs, complicating efforts at smoking cessation, and requiring a broader approach than standard nicotine-dependence interventions.
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Tabuchi T, Goto A, Ito Y, Fukui K, Miyashiro I, Shinozaki T. Smoking at the time of diagnosis and mortality in cancer patients: What benefit does the quitter gain? Int J Cancer 2017; 140:1789-1795. [PMID: 28073149 DOI: 10.1002/ijc.30601] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/16/2016] [Accepted: 12/29/2016] [Indexed: 11/11/2022]
Abstract
Few studies have examined the association between smoking behavior (especially quitters) at the time of diagnosis and mortality among cancer patients. Our objective was to examine the benefits of quitting on all-cause mortality among cancer patients. 30,658 eligible cancer patients diagnosed between 1985 and 2009, identified by a hospital-based cancer registry in Japan, were followed up for up to 10 years. We evaluated smoking behavior at cancer diagnosis (especially recent quitters vs. current smokers) in association with all-cause mortality using Cox-proportional hazards models and covariates-adjusted survival curves. Risk of death was estimated to be reduced by 11% in recent quitters compared with current smokers. According to adjusted survival curves, median survival time was 8.25 years for recent quitters versus 7.18 years for current smokers, indicating an absolute difference of 1.07 year for a median survivor. Similarly, never and former smokers had 18% and 16% lower risk of death with 1.90 years and 1.77 years gained, respectively, compared with current smokers. In addition to former and never smokers, recent quitters showed consistently higher survival rates than current smokers during the 10-year calendar period after diagnosis among cancer patients. Because recent quitters may be similar to patients who stop smoking shortly after cancer diagnosis in terms of smoking duration, the latter may be able to decrease their risk of death, suggesting that smoking cessation could be part of cancer care.
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Affiliation(s)
- Takahiro Tabuchi
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka, Japan
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-Ku, Tokyo, Japan
| | - Yuri Ito
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka, Japan
| | - Keisuke Fukui
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka, Japan
| | - Isao Miyashiro
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Higashinari-Ku, Osaka, Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan
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Chang EHE, Braith A, Hitsman B, Schnoll RA. Treating Nicotine Dependence and Preventing Smoking Relapse in Cancer Patients. EXPERT REVIEW OF QUALITY OF LIFE IN CANCER CARE 2016; 2:23-39. [PMID: 28808692 PMCID: PMC5553981 DOI: 10.1080/23809000.2017.1271981] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations. AREAS COVERED We reviewed the latest evidence for smoking cessation treatments for cancer patients and the clinical guidelines and recommendation available for oncologists and health care providers. The unique aspects of nicotine dependence among patients diagnosed with cancer, and key challenges and barriers that cancer survivors and health care providers experience when considering smoking cessation treatments, and available clinical resources, are also discussed. Lastly, the authors summarize future directions in the field of smoking cessation treatment for cancer patients. EXPERT COMMENTARY While there are areas of improvement in research of smoking cessation treatment for cancer patients, critical under-explored areas remain. Nonetheless, providers should adhere to the NCCN guidelines and offer a brief counseling intervention to motivate patients to quit smoking when appropriate resources are not available.
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Affiliation(s)
- Eun Hae Estelle Chang
- Department of Otolaryngology Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, Phone 402-559-8007 Fax 402-559-8490
| | - Andrew Braith
- College of Medicine, University of Nebraska Medical Center, 42 Street and Emile Street, Omaha, NE 68198
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine & Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 680 N Lake Shore Drive, Suite 1400, Chicago, IL 60611, Phone 312-503-2074
| | - Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, 3535 Market Street, 4 Floor, Philadelphia, PA 19104, Phone 215-746-7143 Fax 215-746-7140
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Díaz DB, Brandon TH, Sutton SK, Meltzer LR, Hoehn HJ, Meade CD, Jacobsen PB, McCaffrey JC, Haura EB, Lin HY, Simmons VN. Smoking relapse-prevention intervention for cancer patients: Study design and baseline data from the surviving SmokeFree randomized controlled trial. Contemp Clin Trials 2016; 50:84-9. [PMID: 27468664 DOI: 10.1016/j.cct.2016.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/15/2016] [Accepted: 07/17/2016] [Indexed: 11/29/2022]
Abstract
Continued smoking after a cancer diagnosis contributes to several negative health outcomes. Although many cancer patients attempt to quit smoking, high smoking relapse rates have been observed. This highlights the need for a targeted, evidence-based smoking-relapse prevention intervention. The design, method, and baseline characteristics of a randomized controlled trial assessing the efficacy of a self-help smoking-relapse prevention intervention are presented. Cancer patients who had recently quit smoking were randomized to one of two conditions. The Usual Care (UC) group received the institution's standard of care. The smoking relapse-prevention intervention (SRP) group received standard of care, plus 8 relapse-prevention booklets mailed over a 3month period, and a targeted educational DVD developed specifically for cancer patients. Four hundred and fourteen participants were enrolled and completed a baseline survey. Primary outcomes will be self-reported smoking status at 6 and 12-months after baseline. Biochemical verification of smoking status was completed for a subsample. If found to be efficacious, this low-cost intervention could be easily disseminated with significant potential for reducing the risk of negative cancer outcomes associated with continued smoking.
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Affiliation(s)
- Diana B Díaz
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States.
| | - Thomas H Brandon
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Steven K Sutton
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Lauren R Meltzer
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States.
| | - Hannah J Hoehn
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States.
| | - Cathy D Meade
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Paul B Jacobsen
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Judith C McCaffrey
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States
| | - Eric B Haura
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
| | - Hui-Yi Lin
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States.
| | - Vani N Simmons
- H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, United States; University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, United States.
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Lucchiari C, Masiero M, Botturi A, Pravettoni G. Helping patients to reduce tobacco consumption in oncology: a narrative review. SPRINGERPLUS 2016; 5:1136. [PMID: 27504234 PMCID: PMC4954805 DOI: 10.1186/s40064-016-2798-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 07/08/2016] [Indexed: 11/10/2022]
Abstract
The present overview focuses on evidence of smoking cessation approaches in oncology settings with the aim to provide health personnel a critical perspective on how to help their patients. This narrative review is structured in two main sections: the first one describes the psycho-cognitive variables involved in the decision to continue smoking after a cancer diagnosis and during the treatment; the second section relates methods and tools may be recommended, being evidence-based, to support smoking cessation in oncology settings. Active smoking increases not only susceptibility to common cancers in the general population, but also increases disease severity and comorbidities in cancer patients. Nowadays, scientific evidence has identified many strategies to give up smoking, but a lack of knowledge exists for treatment of nicotine dependence in the cancer population. Health personnel is often ambiguous when approaching the problem, while their contribution is essential in guiding patients towards healthier choices. We argue that smoking treatments for cancer patients deserve more attention and that clinical features, individual characteristics and needs of the patient should be assessed in order to increase the attempts success rate. Health personnel that daily work and interact with cancer patients and their caregivers have a fundamental role in the promotion of the health changing. For this reason, it is important that they have adequate knowledge and resources in order to support cancer patients to stop tobacco cigarette smoking and promoting and healthier lifestyle.
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Affiliation(s)
- Claudio Lucchiari
- />Department of Philosophy, Università degli Studi di Milano, Milan, Italy
| | - Marianna Masiero
- />Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- />Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Andrea Botturi
- />Department of Neurooncology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Gabriella Pravettoni
- />Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- />Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
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Burris JL, Studts JL, DeRosa AP, Ostroff JS. Systematic Review of Tobacco Use after Lung or Head/Neck Cancer Diagnosis: Results and Recommendations for Future Research. Cancer Epidemiol Biomarkers Prev 2015; 24:1450-61. [PMID: 26282629 PMCID: PMC4592460 DOI: 10.1158/1055-9965.epi-15-0257] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 07/29/2015] [Indexed: 11/16/2022] Open
Abstract
Tobacco use after cancer diagnosis is associated with adverse cancer outcomes, yet reliable prevalence estimates for this behavior are lacking. We conducted a systematic literature review of the prevalence of current tobacco use among individuals with a history of lung or head/neck cancer (CRD #42012002625). An extensive search of electronic databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, and Web of Science) identified 7,777 potentially relevant articles published between 1980 and 2014 and 131 of these yielded pertinent information. Aggregating results across heterogeneous study designs and diverse patient samples, the overall mean prevalence rate of current tobacco use (mostly cigarette smoking) was 33.0% (median, 31.0%). Among current tobacco users at cancer diagnosis, the mean prevalence rate of current tobacco use (mostly cigarette smoking) was 53.8% (median, 50.3%). In many cases, an operational definition of "current" tobacco use was absent, and biochemical verification of self-reported smoking status was infrequent. These and other observed methodologic limitations in the assessment and reporting of cancer patients' tobacco use underscore the necessity of uniform tobacco use assessment in future clinical research and cancer care.
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Affiliation(s)
- Jessica L Burris
- Lucille P. Markey Cancer Center, Cancer Prevention and Control Program, Lexington, Kentucky. University of Kentucky, Department of Psychology, Lexington, Kentucky.
| | - Jamie L Studts
- Lucille P. Markey Cancer Center, Cancer Prevention and Control Program, Lexington, Kentucky. University of Kentucky, Department of Behavioral Science, Lexington, Kentucky
| | - Antonio P DeRosa
- Memorial Sloan Kettering Cancer Center, Medical Library, New York, New York
| | - Jamie S Ostroff
- Memorial Sloan Kettering Cancer Center, Psychiatry and Behavioral Sciences Service, New York, New York
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Warren GW, Ward KD. Integration of tobacco cessation services into multidisciplinary lung cancer care: rationale, state of the art, and future directions. Transl Lung Cancer Res 2015; 4:339-52. [PMID: 26380175 DOI: 10.3978/j.issn.2218-6751.2015.07.15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 07/16/2015] [Indexed: 12/31/2022]
Abstract
Tobacco use is the largest risk factor for lung cancer and many lung cancer patients still smoke at the time of diagnosis. Although clinical practice guidelines recommend that all patients receive evidence-based tobacco treatment, implementation of these services in oncology practices is inconsistent and inadequate. Multidisciplinary lung cancer treatment programs offer an ideal environment to optimally deliver effective smoking cessation services. This article reviews best practice recommendations and current status of tobacco treatment for oncology patients, and provides recommendations to optimize delivery of tobacco treatment in multidisciplinary practice.
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Affiliation(s)
- Graham W Warren
- 1 Department of Cell and Molecular Pharmacology and Experimental Therapeutics and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA ; 2 Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
| | - Kenneth D Ward
- 1 Department of Cell and Molecular Pharmacology and Experimental Therapeutics and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA ; 2 Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA
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Surgical lung cancer patients' views about smoking and support to quit after diagnosis: a qualitative study. J Cancer Surviv 2015; 10:312-9. [PMID: 26298019 DOI: 10.1007/s11764-015-0477-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Evidence suggests that quitting smoking improves symptoms as well as disease-related mortality for cancer patients. However, smoking cessation support is typically not well integrated into routine cancer care even in the case of lung cancer.. We explored surgical lung cancer patients' views about smoking and about their preferences for support to help them to quit. METHODS We conducted semi-structured, qualitative interviews with 22 surgical lung cancer patients with a smoking history, after treatment with surgery. Data were analysed using the framework approach. RESULTS Although diagnosis promoted a successful quit attempt in some, others continued smoking or relapsed after a quit attempt. Most participants wished they were a non-smoker but, in conflict with this, also felt that smoking was enjoyable, helped with psychological coping or had some health benefits. Some also demonstrated a fatalist attitude towards the potential detrimental health effects. However, all participants felt that it was important for health professionals to address smoking and some wanted cessation support although it was often not provided. Participants wanted support to start as early as possible and to continue for the first weeks after discharge. CONCLUSIONS Surgical lung cancer patients often stop smoking during hospitalisation, and many want to remain quit but relapse shortly after discharge. Although it is often not provided, many patients want to be offered support to help them quit. IMPLICATIONS FOR CANCER SURVIVORS Surveys suggest that clinicians believe that addressing smoking will be difficult and/or unwanted. However, these findings suggest that surgical lung cancer patients would tolerate, and most would prefer, integration of smoking cessation support into routine cancer care.
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Regan T, Carey M, Bryant J, Waller A, Mansfield E, Sitas F, Tracey E. Prevalence and correlates of current smoking among medical oncology outpatients. Psychooncology 2015; 24:1258-1264. [DOI: 10.1002/pon.3893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 05/25/2015] [Accepted: 06/02/2015] [Indexed: 01/03/2023]
Affiliation(s)
- Tim Regan
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
| | - Mariko Carey
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
| | - Jamie Bryant
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
| | - Amy Waller
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
| | - Elise Mansfield
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
| | - Freddy Sitas
- Cancer Research Division; Cancer Council NSW; Kings Cross New South Wales Australia
| | - Elizabeth Tracey
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour; University of Newcastle; Callaghan New South Wales Australia
- Hunter Medical Research Institute; New Lambton New South Wales Australia
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Tabuchi T, Fujiwara T. Are secondhand smoke-related diseases of children associated with parental smoking cessation? Determinants of parental smoking cessation in a population-based cohort study. Prev Med 2015; 73:81-7. [PMID: 25660485 DOI: 10.1016/j.ypmed.2015.01.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/26/2014] [Accepted: 01/26/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Little is known about whether secondhand smoke (SHS)-related diseases of young children, such as asthma, induce parental smoking cessation during the early child-rearing period. Our objective was therefore to show the association in addition to other potential determinants of parental cessation. METHODS We analyzed data from the Longitudinal Survey of Newborns in the 21st Century in Japan, from 0.5years (N=47,015) to 4.5years (N=39,817), having selected participants whose parents smoked at baseline (maternal smoking N=8,037; paternal smoking N=28,486). Multivariable log-binomial regression models were used to calculate the prevalence ratios for parental smoking cessation according to the onset of SHS-related diseases of their children, using inverse probability weight to account for non-response at follow-up. RESULTS A total of 16.7% of smoking mothers and 14.5% of smoking fathers had stopped smoking at follow-up. The onset of SHS-related children's diseases was not statistically significantly associated with either maternal or paternal smoking cessation after multivariable adjustments. Strong determinants were, for example, number of cigarettes smoked per day and partner's smoking status during follow-up. CONCLUSION SHS-related children's diseases were not associated with parental smoking cessation. It may therefore be necessary to provide additional support for parental smoking cessation within their child's medical care setting.
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Affiliation(s)
- Takahiro Tabuchi
- Center for Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, 3-3, Nakamichi 1-chome, Higashinari-ku, Osaka-shi, Osaka 537-8511, Japan; Department of Social Medicine, National Research Institute for Child Health and Development,2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development,2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
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Shiels MS, Gibson T, Sampson J, Albanes D, Andreotti G, Beane Freeman L, Berrington de Gonzalez A, Caporaso N, Curtis RE, Elena J, Freedman ND, Robien K, Black A, Morton LM. Cigarette smoking prior to first cancer and risk of second smoking-associated cancers among survivors of bladder, kidney, head and neck, and stage I lung cancers. J Clin Oncol 2014; 32:3989-95. [PMID: 25385740 DOI: 10.1200/jco.2014.56.8220] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Data on smoking and second cancer risk among cancer survivors are limited. We assessed associations between smoking before first cancer diagnosis and risk of second primary smoking-associated cancers among survivors of lung (stage I), bladder, kidney, and head/neck cancers. METHODS Data were pooled from 2,552 patients with stage I lung cancer, 6,386 with bladder cancer, 3,179 with kidney cancer, and 2,967 with head/neck cancer from five cohort studies. We assessed the association between prediagnostic smoking and second smoking-associated cancer risk with proportional hazards regression, and compared these estimates to those for first smoking-associated cancers in all cohort participants. RESULTS Compared with never smoking, current smoking of ≥ 20 cigarettes per day was associated with increased second smoking-associated cancer risk among survivors of stage I lung (hazard ratio [HR] = 3.26; 95% CI, 0.92 to 11.6), bladder (HR = 3.67; 95% CI, 2.25 to 5.99), head/neck (HR = 4.45; 95% CI, 2.56 to 7.73), and kidney cancers (HR = 5.33; 95% CI, 2.55 to 11.1). These estimates were similar to those for first smoking-associated cancer among all cohort participants (HR = 5.41; 95% CI, 5.23 to 5.61). The 5-year cumulative incidence of second smoking-associated cancers ranged from 3% to 8% in this group of cancer survivors. CONCLUSION Understanding risk factors for second cancers among cancer survivors is crucial. Our data indicate that cigarette smoking before first cancer diagnosis increases second cancer risk among cancer survivors, and elevated cancer risk in these survivors is likely due to increased smoking prevalence. The high 5-year cumulative risks of smoking-associated cancers among current smoking survivors of stage I lung, bladder, kidney, and head/neck cancers highlight the importance of smoking cessation in patients with cancer.
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Affiliation(s)
- Meredith S Shiels
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC.
| | - Todd Gibson
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Joshua Sampson
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Demetrius Albanes
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Gabriella Andreotti
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Laura Beane Freeman
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Amy Berrington de Gonzalez
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Neil Caporaso
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Rochelle E Curtis
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Joanne Elena
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Neal D Freedman
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Kim Robien
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Amanda Black
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Lindsay M Morton
- Meredith S. Shiels, Todd Gibson, Joshua Sampson, Demetrius Albanes, Gabriella Andreotti, Laura Beane Freeman, Amy Berrington de Gonzalez, Neil Caporaso, Rochelle E. Curtis, Joanne Elena, Neal D. Freedman, Amanda Black, and Lindsay M. Morton, National Cancer Institute, Rockville, MD; Todd Gibson, St Jude's Children's Research Hospital, Memphis, TN; and Kim Robien, Milken Institute School of Public Health, George Washington University, Washington, DC
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Gritz ER, Toll BA, Warren GW. Tobacco use in the oncology setting: advancing clinical practice and research. Cancer Epidemiol Biomarkers Prev 2014; 23:3-9. [PMID: 24420982 DOI: 10.1158/1055-9965.epi-13-0896] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although tobacco is a well-established causal agent for many human cancers, less emphasis has been placed on translating this evidence by evaluating the effects of continued tobacco use after a cancer diagnosis. A broad assessment of the effects of continued tobacco use demonstrates that tobacco increases cancer treatment toxicity, recurrence, second primary tumors, and mortality in patients with cancer. Few studies report the potential benefits of cessation after a cancer diagnosis, but data suggest improved treatment outcomes in patients with cancer who quit smoking. Improving tobacco cessation treatment efficacy and access to cessation support has been sparsely researched in the oncology setting compared with the general population; however, patients with cancer are receptive to standard evidence-based tobacco cessation guidelines. Several studies demonstrate moderate tobacco cessation success in patients with cancer using the general principles of evidence-based tobacco cessation support. Several systems-level issues and research efforts are needed to standardize tobacco use definitions, increase access to tobacco cessation support, improve tobacco cessation efficacy, understand the time-dependent effects of tobacco and cessation on cancer biology, and realize the potential benefits of tobacco cessation for patients with cancer.
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Affiliation(s)
- Ellen R Gritz
- Authors' Affiliations: The University of Texas MD Anderson Cancer Center, Houston, Texas; Yale University School of Medicine; Yale Cancer Center; Smilow Cancer Hospital at Yale-New Haven, New Haven, Connecticut; and Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina
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McDonnell KK, Bullock LF, Kozower BD, Hollen PJ, Heath J, Rovnyak V. A Decision Aid to Improve Smoking Abstinence for Families Facing Cancer. Oncol Nurs Forum 2014; 41:649-58. [DOI: 10.1188/14.onf.649-658] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bloom EL, Oliver JA, Sutton SK, Brandon TH, Jacobsen PB, Simmons VN. Post-operative smoking status in lung and head and neck cancer patients: association with depressive symptomatology, pain, and fatigue. Psychooncology 2014; 24:1012-9. [PMID: 25257853 DOI: 10.1002/pon.3682] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/24/2014] [Accepted: 08/21/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE An estimated 35-50% of lung and head and neck cancer patients are smoking at diagnosis; most try to quit; however, a substantial proportion resumes smoking. As cancer treatments improve, attention to the effects of continued smoking on quality of life in the survivorship period is increasing. The current study examines if smoking abstinence following surgical treatment is associated with better quality of life. METHODS Participants were 134 patients with head and neck or lung cancer who received surgical treatment. Smoking status and indices of quality of life (depressive symptoms, fatigue, and pain) were assessed at the time of surgery (baseline) and at 2, 4, 6, and 12 months post-surgery. Analyses were performed using a generalized estimating equations approach. A series of models examined the correlation between smoking status and post-surgery quality of life while adjusting for demographics, clinical variables, and baseline smoking status and quality of life. RESULTS Continuous post-surgery abstinence was associated with lower levels of depressive symptoms and fatigue; however, the relationship with fatigue became nonsignificant after adjusting for baseline fatigue and income. There was no significant relationship observed between smoking status and pain. CONCLUSIONS Findings add to a growing literature showing that smoking cessation is not associated with detrimental effects on quality of life and may have beneficial effects, particularly with regard to depressive symptoms. Such information can be used to motivate smoking cessation and continued abstinence among cancer patients and increase provider comfort in recommending cessation.
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Affiliation(s)
- Erika Litvin Bloom
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| | - Jason A Oliver
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Steven K Sutton
- Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Paul B Jacobsen
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
| | - Vani Nath Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.,Department of Psychology, University of South Florida, Tampa, FL, USA.,Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA
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Smoking cessation dialogue and the complementary therapist: reluctance to engage? Complement Ther Clin Pract 2014; 20:181-7. [PMID: 25168007 DOI: 10.1016/j.ctcp.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/23/2014] [Accepted: 07/29/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Our aim was to explore the experiences and views of complementary therapists (CT) regarding smoking cessation (SC) support within the oncology setting. METHODS Two oncology sites participated in the North West of England. Three focus groups were conducted (n = 19) with resulting transcripts thematically analysed. Demographic data was collected via a short questionnaire. RESULTS Reasons were given for reluctance to engage in SC support, these included; fear of comprising the therapeutic relationship, patient's poor motivation and/or those living with life limiting disease. Nicotine Replacement Therapy (NRT) advice was regarded as a 'medical' activity. There was evidence of smoker-related stigmatisation. CONCLUSION This study provided insights in how complementary therapists view a potential SC role. Research is needed to determine whether the findings are common to other areas of CT practice. Further training in SC support is suggested for those working in oncology settings.
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Smoking is a perioperative risk factor and prognostic factor for lung cancer surgery. Gen Thorac Cardiovasc Surg 2014; 63:93-8. [PMID: 25085320 DOI: 10.1007/s11748-014-0461-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 07/26/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the smoking status of lung cancer patients and to confirm the risk of smoking for patients undergoing lung cancer surgery. METHODS We conducted a retrospective study of patients undergoing lung cancer surgery. Between May 2004 and March 2013, 716 patients underwent lung cancer surgery at our institution. Based on smoking status, the patients were classified into 3 groups: nonsmoker, past smoker, and current smoker. Based on exclusion criteria, a final total of 670 patients were investigated for the association between smoking status and postoperative complications. In addition, we explored the effect of smoking on survival after surgery. RESULTS There were 254 non-smokers, 246 past smokers, and 170 current smokers. The percent of female patients, adenocarcinoma, and stage IA cancer was highest in the nonsmokers. Respiratory function was significantly impaired in past and current smokers. Respiratory and cardiac complications were found less frequently in non-smokers (11.4%) followed by 17.1% of past smokers and 21.2% of current smokers (p = 0.0226). Univariate analysis showed that smoking was a significantly poor prognostic factor for overall survival. The 5-year survival rates for non-smokers, past, and current smokers were 81.4, 65.4, and 68.8%, respectively (p = 0.0003). CONCLUSIONS Smokers with lung cancer tended to have advanced lung cancer, impaired pulmonary function, and high morbidity after lung cancer surgery. Although multivariate analysis did not show that smoking was associated with poor outcome, non-smokers had significantly better overall survival, even for patients with stage IA lung cancers.
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Vaidya V, Hufstader-Gabriel M, Gangan N, Shah S, Bechtol R. Utilization of smoking-cessation pharmacotherapy among chronic obstructive pulmonary disease (COPD) and lung cancer patients. Curr Med Res Opin 2014; 30:1043-50. [PMID: 24432816 DOI: 10.1185/03007995.2014.884493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Smoking is one of the major risk factors causing morbidity and mortality in chronic obstructive pulmonary disease (COPD) and lung cancer patients. Use of smoking cessation pharmacotherapy is an effective way to help quit smoking. The purpose of the study was to determine the prevalence of smoking and the proportion of patients using smoking cessation agents, and to identify the socio-demographic factors that affect the use of these agents among COPD and lung cancer patients. RESEARCH DESIGN AND METHODS A retrospective study was done to identify smokers having COPD (ICD-9: 490-492) or lung cancer (ICD-9: 162), and those who use smoking cessation agents from 2006-2010, using Medical Expenditure Panel Survey (MEPS) data. A multiple logistic regression model was built to identify significant socio-demographic predictors associated with the use of smoking cessation agents. RESULTS Around 16.8% of COPD patients and 15.1% of lung cancer patients reported smoking after diagnosis. Out of the total smokers, 8.8% patients with COPD and 12.6% patients with lung cancer reported use of smoking cessation agents during the 5 year period. Logistic regression showed that odds for smoking cessation use in COPD patients were lower for Hispanics (OR = 0.107, 95% CI 0.023-0.502) and higher for patients having insurance coverage (OR = 3.453, 95% CI 1.240-9.617). CONCLUSION Results showed that a large number of patients continued to smoke even after the diagnosis of COPD and lung cancer; whereas only a few among them used smoking cessation agents. Ethnicity disparities and insurance status were associated with the use of smoking cessation agents. Differential use among population sub-groups suggests a requirement for need based smoking cessation programs and appropriate prescription drug coverage. Further research needs to be done to evaluate reasons for disparities in smoking cessation agents' use. The study had limitations common to research designs based on observational and self-reported datasets.
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Fujisawa D, Umezawa S, Basaki-Tange A, Fujimori M, Miyashita M. Smoking status, service use and associated factors among Japanese cancer survivors--a web-based survey. Support Care Cancer 2014; 22:3125-34. [PMID: 24848577 DOI: 10.1007/s00520-014-2284-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Abstract
PURPOSE This study aims to investigate smoking status and its associated factors among Japanese cancer survivors. We stretched our focus on association with health-related behaviors other than smoking (alcohol intake, physical exercise, and social activity) and the smoking cessation strategies used by cancer survivors. METHODS An anonymous cross-sectional web-based survey was conducted, enrolling survivors of various types of cancer up to 10 years after diagnosis. Smoking status, socioeconomic status, health-related behaviors other than smoking, and smoking cessation resource that the participants used were evaluated. Factors associated with continuous smoking after cancer diagnosis were explored using multivariate analysis. RESULTS Among 168 participants who were smoking at the time of cancer diagnosis, 96 participants (57.1 %) continued smoking. Sixty-seven survivors (69.8 %) were willing to reduce or quit smoking, however, only 39 survivors (40.6 %) were provided with counseling or intervention on smoking cessation. Male gender, shorter time after cancer diagnosis, and lack of regular physical exercise associated with continuous smoking. Higher level of fear of cancer recurrence had trend-level significance of association with smoking cessation. CONCLUSIONS Substantial proportions of Japanese cancer survivors continue smoking after diagnosis of cancer. The majority of them are not provided with relevant information or support, despite their willingness of reducing or quitting smoking. Smoking cessation is associated with other health behaviors (i.e., physical exercise). This suggests considerable missed opportunities for health-care providers to provide cancer survivors with counseling and evidence-based interventions. Promotion of professional support on smoking cessation and education to encourage healthy behaviors are needed.
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Affiliation(s)
- Daisuke Fujisawa
- Psycho-Oncology Division, National Cancer Center East, Kashiwa, Japan,
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Ehlers SL, Bronars CA, Patten CA, Brockman T, Hughes C, Decker PA, Cerhan JR, Hogan W, Dispenzieri A, Ansell S, Ebbert J, Gastineau D. Accuracy of self-reported tobacco use status among hematopoietic SCT patients. Bone Marrow Transplant 2014; 49:961-5. [PMID: 24732958 PMCID: PMC4162628 DOI: 10.1038/bmt.2014.70] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 02/20/2014] [Accepted: 02/26/2014] [Indexed: 11/21/2022]
Abstract
Tobacco use is a risk factor for adverse outcomes among Hematopoietic Stem Cell Transplant (HSCT) patients. Accurate identification of tobacco use offers a vital opportunity to treat this risk factor. The current study compared self-reported tobacco use status to serum cotinine levels among HSCT patients at time of pre-transplant evaluation. A total of 444 participants completed both assessments; 44 participants (9.9%) were classified as tobacco users with serum cotinine concentrations > 2ng/Ml versus 29 with self-report. Sensitivity and specificity of self-report were 65.9% and 100%. Positive predictive and negative predictive values were 100% and 96.4%. Comparing tobacco use documented in the medical record with cotinine, sensitivity and specificity were 51.2% and 99.2%. Factors associated with tobacco use were male gender, single relationship status, less education, and younger age. In summary, utilization of serum cotinine assays increased detection of tobacco use cases more than 50% over self-report. Results are discussed in context of translation to care, including clinical and ethical implications, and current tobacco use treatment guidelines. When cotinine assays are not available, self-report of any tobacco use in the year prior to HSCT should trigger brief advice and cessation or relapse prevention counseling.
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Affiliation(s)
- S L Ehlers
- 1] Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA [2] Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - C A Bronars
- 1] Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA [2] Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - C A Patten
- 1] Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA [2] Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - T Brockman
- Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - C Hughes
- Behavioral Health Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - P A Decker
- Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - J R Cerhan
- Division of Epidemiology, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - W Hogan
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - A Dispenzieri
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - S Ansell
- Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - J Ebbert
- 1] Nicotine Dependence Center Research Program, Mayo Clinic College of Medicine, Rochester, MN, USA [2] Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - D Gastineau
- 1] Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA [2] Human Cellular Therapy Laboratory, Mayo Clinic College of Medicine, Rochester, MN, USA
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Smoking Prevention and Cessation. Lung Cancer 2014. [DOI: 10.1002/9781118468791.ch1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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