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Eng L, Su J, Qiu X, Palepu PR, Hon H, Fadhel E, Harland L, La Delfa A, Habbous S, Kashigar A, Cuffe S, Shepherd FA, Leighl NB, Pierre AF, Selby P, Goldstein DP, Xu W, Liu G. Second-Hand Smoke As a Predictor of Smoking Cessation Among Lung Cancer Survivors. J Clin Oncol 2014; 32:564-70. [DOI: 10.1200/jco.2013.50.9695] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated with cessation rates in lung cancer survivors. Patients and Methods Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting. Results In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio [aOR], 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes. Conclusion SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.
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Affiliation(s)
- Lawson Eng
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Jie Su
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Xin Qiu
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Prakruthi R. Palepu
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Henrique Hon
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Ehab Fadhel
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Luke Harland
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Anthony La Delfa
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Steven Habbous
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Aidin Kashigar
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Sinead Cuffe
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Frances A. Shepherd
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Natasha B. Leighl
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Andrew F. Pierre
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - David P. Goldstein
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Wei Xu
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
| | - Geoffrey Liu
- Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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