1
|
Gregory K, Zhao L, Felder TM, Clay-Gilmour A, Eberth JM, Murphy EA, Steck SE. Prevalence of health behaviors among cancer survivors in the United States. J Cancer Surviv 2024; 18:1042-1050. [PMID: 36933085 PMCID: PMC10024006 DOI: 10.1007/s11764-023-01347-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/07/2023] [Indexed: 03/19/2023]
Abstract
PURPOSE We determined the proportion of cancer survivors who met each of five health behavior guidelines recommended by the American Cancer Society (ACS), including consuming fruits and vegetables at least five times/day, maintaining a body mass index (BMI) < 30 kg/m2, engaging in 150 min or more of physical activity weekly, not currently smoking, and not excessively drinking alcohol. METHODS Using data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), 42,727 survey respondents who reported a previous diagnosis of cancer (excluding skin cancer) were included. Weighted percentages with 95% confidence intervals (95% CI) were estimated for the five health behaviors accounting for BRFSS' complex survey design. RESULTS The weighted percentage of cancer survivors who met ACS guidelines was 15.1% (95%CI: 14.3%, 15.9%) for fruit and vegetable intake; 66.8% (95%CI: 65.9%, 67.7%) for BMI < 30 kg/m2; 51.1% (95%CI: 50.1%, 52.1%) for physical activity; 84.9% (95%CI: 84.1%, 85.7%) for not currently smoking; and 89.5% (95%CI: 88.8%, 90.3%) for not drinking excessive alcohol. Adherence to ACS guidelines among cancer survivors generally increased with increasing age, income, and education. CONCLUSIONS While the majority of cancer survivors met the guidelines for not smoking and limiting alcohol drinking, one-third had elevated BMI, almost half did not meet recommended physical activity levels, and the majority had inadequate fruit and vegetable intake. IMPLICATIONS FOR CANCER SURVIVORS Adherence to guidelines was lowest among younger cancer survivors and those with lower income and education, suggesting these may be populations where resources could be targeted to have the greatest impact.
Collapse
Affiliation(s)
- Katherine Gregory
- South Carolina Honors College, University of South Carolina, Columbia, SC, 29208, USA
| | - Longgang Zhao
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Rm 456, Discovery I Building, Columbia, SC, 29208, USA
| | - Tisha M Felder
- College of Nursing, University of South Carolina, Columbia, SC, 29208, USA
| | - Alyssa Clay-Gilmour
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Rm 456, Discovery I Building, Columbia, SC, 29208, USA
| | - Jan M Eberth
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Rm 456, Discovery I Building, Columbia, SC, 29208, USA
- Department of Health Management and Policy, Drexel University, Philadelphia, PA, 19104, USA
| | - E Angela Murphy
- Department of Pathology, Microbiology, and Immunology, School of Medicine, University of South Carolina, Columbia, SC, 29208, USA
| | - Susan E Steck
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Rm 456, Discovery I Building, Columbia, SC, 29208, USA.
| |
Collapse
|
2
|
González Ruiz LM, Mondragón Márquez LI, Domínguez Bueso DL, Liu JJ. Prevalence of Current Cigarette Smoking by Sociodemographic Characteristics in U.S. Cancer Survivors. Subst Use Misuse 2024; 59:486-493. [PMID: 37970728 DOI: 10.1080/10826084.2023.2280587] [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] [Indexed: 11/17/2023]
Abstract
BACKGROUND Cancer survivors are especially vulnerable to the carcinogenic effects of tobacco smoking, but there lacks a study comprehensively examining the sociodemographic disparities in current smoking prevalence in this population. In this study, we quantified the current cigarette smoking prevalence in cancer survivors and those without cancer history by sociodemographic factors, to identify subpopulations with high current smoking burden. METHODS We conducted a cross-sectional study of 3,679 cancer survivors and 27,350 participants without cancer history who were 18 years of age or above in the 2019 National Health Interview Survey. Data for the study variables were obtained from computer-assisted personal or telephone interviews. Weighted Poisson regression was used to estimate prevalence ratios and 95% confidence intervals. RESULTS Although the current smoking prevalence for cancer survivors was slightly lower than for those without cancer history, the prevalence exceeded 30% in cancer survivors in poverty or without health insurance. Individuals with significantly higher current smoking prevalence had lower education levels, were unmarried, did not have health insurance, or lived in poverty. The associations of age, sex, race, health insurance status, and poverty status with current smoking significantly differed between cancer survivors and those without cancer history. Sociodemographic disparities in current smoking prevalence were found in survivors of either smoking-related or nonsmoking-related cancers. CONCLUSION High current smoking prevalence still exists in subpopulations of cancer survivors and those without cancer history. Our findings may strengthen efforts to reduce sociodemographic disparities in current smoking prevalence and to lower the overall smoking prevalence.
Collapse
Affiliation(s)
- Liza M González Ruiz
- International Health Program, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | | | - Jason J Liu
- International Health Program, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
3
|
McMenamin E, Gottschalk AB, Pucci DA, Jacobs LA. Health behaviors among head and neck cancer survivors. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:48. [PMID: 37248541 PMCID: PMC10226230 DOI: 10.1186/s41043-023-00390-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/19/2023] [Indexed: 05/31/2023]
Abstract
PURPOSE To determine to what extent head and neck cancer (HNC) survivors participate in health behaviors (HBs) recommended by the National Cancer Center Network (NCCN®). METHODS Participants identified through the tumor registries at the Abramson Cancer Center (ACC), University of Pennsylvania and affiliated sites. Eligibility: (a) diagnosis and treatment HNC; (b) aged 18 to 70 years; (c) ≥ 1-year post-diagnosis; (d) human papillomavirus (HPV) status confirmed; (e) ability to understand written English. Potential participants received an explanation of the study, informed consent, self-reported questionnaire, and self-addressed stamped envelope. RESULTS 451 individuals eligible, 102 (23%) agreed to participate, HPV positive (74%). Current smoking rare (7%), historical use common (48%). Current alcohol use common (65%), average 2.1 drinks/day, 12 days/month. 22% binge drank with an average of 3.5 binge-drinking sessions per month. Nutritional behavior mean 7.1 (range 0-16), lower scores indicating better nutrition. Body mass index (BMI) 59% overweight/obese. Adequate aerobic exercise 59%, adequate strength and flexibility 64%. Leisure time activity, 18% sedentary, 19% moderately active, 64% active. All participants reported having a primary care physician, 92% seen in the previous 12 months. CONCLUSIONS Most HNC survivors participated in some HBs. Current smoking rarely reported, binge drinking and high BMI most common negative HBs. Opportunities remain to improve dietary and exercise behaviors. IMPLICATIONS FOR CANCER SURVIVORS The NCCN® has outlined HBs that decrease likelihood of cancer survivors developing comorbidities that could impact overall survival. It is incumbent on healthcare providers to educate and encourage cancer survivors to participate in these HBs.
Collapse
Affiliation(s)
- Erin McMenamin
- Abramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, South Tower 10-149, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Abigail Blauch Gottschalk
- Abramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, South Tower 10-149, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Donna A Pucci
- Abramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, South Tower 10-149, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Linda A Jacobs
- Abramson Cancer Center, Perelman Center for Advanced Medicine, University of Pennsylvania, South Tower 10-149, 3400 Civic Center Boulevard, Philadelphia, PA, 19104, USA.
| |
Collapse
|
4
|
Bui TT, Han M, Luu NM, Tran TPT, Kim SY, Kim YA, Lim MK, Oh JK. Mortality risk according to smoking trajectories after cancer diagnosis among Korean male cancer survivors: A population-based cohort study. Tob Induc Dis 2023; 21:69. [PMID: 37252030 PMCID: PMC10210093 DOI: 10.18332/tid/163175] [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: 02/20/2023] [Revised: 04/01/2023] [Accepted: 04/11/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION Previous research on post-diagnosis smoking among cancer survivors mainly relied on smoking status, which may not fully reflect the impact of changes in smoking levels. This study aimed to evaluate mortality risk according to smoking trajectories among Korean male cancer survivors, using a trajectory approach to comprehensively capture smoking patterns. METHODS The study included 110555 men diagnosed with cancer between 2002 and 2018 from the Korean National Health Information Database. Group-based trajectory modelling was used to identify post-diagnosis smoking trajectories among pre-diagnosis current smokers (n=45331). Cox hazards models were fitted to evaluate mortality risk according to smoking trajectories for pooled cancers, pooled smoking-related cancers, smoking-unrelated cancers, and gastric, colorectal, liver, and lung cancers. RESULTS Smoking trajectories included light-smoking quitters, heavy-smoking quitters, consistent moderate smokers, and decreasing heavy smokers. Smoking significantly increased all-cause and cancer mortality risks in cancer patients for pooled cancers, pooled smoking-related cancers, and pooled smoking-unrelated cancers. Compared to non-smokers, all-cause mortality risk for pooled cancers significantly increased according to smoking trajectories:(AHR=1.33; 95% CI: 1.27-1.40), (AHR=1.39; 95% CI: 1.34-1.44), (AHR=1.44; 95% CI: 1.34-1.54), and (AHR=1.47; 95% CI: 1.36-1.60), respectively. Smoking increased all-cause and cancer mortality risks in gastric and colorectal cancer patients and cancer-specific mortality in lung cancer patients. The significant associations of smoking trajectories with all-cause and cancer mortality risks were primarily observed in 5-year survivors but not in short-term survivors. Among heavy smokers, smoking cessation significantly reduced all-cause mortality risk in the long-term. CONCLUSIONS The post-diagnosis smoking trajectory independently predicts cancer prognosis among male cancer patients. Proactive cessation support should be strengthened, particularly for those who smoke heavily.
Collapse
Affiliation(s)
- Thi Tra Bui
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Minji Han
- Department of Health Science and Technology, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Republic of Korea
| | - Ngoc Minh Luu
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Thi Phuong Thao Tran
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Sun Young Kim
- Department of Cancer AI and Digital Health, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Young Ae Kim
- Cancer Survivorship Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| |
Collapse
|
5
|
Millar MM, Herget KA, Ofori-Atta B, Codden RR, Edwards SL, Carter ME, Belnap B, Kirchhoff AC, Sweeney C. Cancer survivorship experiences in Utah: an evaluation assessing indicators of survivors' quality of life, health behaviors, and access to health services. Cancer Causes Control 2023; 34:337-347. [PMID: 36723708 PMCID: PMC10367944 DOI: 10.1007/s10552-023-01671-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 01/14/2023] [Indexed: 02/02/2023]
Abstract
PURPOSE The 2016-2020 Utah Comprehensive Cancer Prevention and Control Plan prioritized strategies to address cancer survivorship experiences. In this paper we present estimates for nine indicators evaluating these priorities, trends over time, and assess disparities in survivorship experiences across demographic subgroups. METHODS We surveyed a representative sample of Utah cancer survivors diagnosed between 2012 and 2019 with any reportable cancer diagnosis. We calculated weighted percentages and 95% confidence intervals (CI) for each indicator. We assessed change over time using a test for trend across survey years in a logistic regression model and used Rao-Scott F-adjusted chi-square tests to test the association between demographic characteristics and each survivorship indicator. RESULTS Most of the 1,793 respondents (93.5%) reported their pain was under control, 85.7% rated their overall health as good, very good, or excellent, but 46.5% experienced physical, mental, or emotional limitations. Only 1.7% of survivors aged 75 or older were current smokers, compared to 5.8% of 65-74-year-olds and 7.9% of survivors aged 55-74 (p < 0.006). No regular physical activity was reported by 20.6% and varied by survivor age and education level. The proportion who received a survivorship care plan increased from 34.6% in 2018 to 43.0% in 2021 (p = 0.025). However, survivors under age 55 were significantly less likely to receive a care plan than older survivors. CONCLUSION This representative survey of cancer survivors fills a gap in understanding of the cancer survivorship experience in Utah. Results can be used to evaluate and plan additional interventions to improve survivorship quality of life.
Collapse
Affiliation(s)
- Morgan M Millar
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA.
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
| | | | | | - Rachel R Codden
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
| | - Sandra L Edwards
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
| | | | - Brad Belnap
- Utah Department of Health and Human Services, Utah Cancer Control Program, Salt Lake City, UT, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah, Salt Lake City, UT, USA
- Division of Epidemiology, University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
6
|
Addison S, Shirima D, Aboagye-Mensah EB, Dunovan SG, Pascal EY, Lustberg MB, Arthur EK, Nolan TS. Effects of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes in cancer survivors: a systematic review. J Cancer Surviv 2022; 16:1023-1046. [PMID: 34357555 PMCID: PMC8342979 DOI: 10.1007/s11764-021-01094-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE Healthy lifestyle (HL) behaviors and cognitive behavioral therapy (CBT) have been individually shown to improve adverse effects of cancer treatment. Little is known about how such programs in tandem affect health-related outcomes. This review evaluates extant literature on tandem CBT/HL interventions on health-related outcomes in cancer survivors. METHODS A comprehensive search of PubMed, PsychINFO, CINAHL, and Embase databases revealed numerous studies involving CBT and HL tandem interventions in cancer survivors in the last 20 years. Studies meeting the inclusion criteria were examined and assessed by the authors. RESULTS The 36 studies included 5199 participants. Interventions involved the use of CBT in combination with a HL condition (stress reduction, increasing physical activity, etc.). These tandem conditions were compared against no intervention, usual care, and/or CBT alone or HL alone. Interventions were delivered by a variety of interventionists, and over different durations. The most common HL target outcomes were stress, and insomnia. Most studies (31 of 36) reported a reduction in adverse treatment and/or cancer-related effects. CONCLUSION Findings were biased with the overrepresentation of breast cancer survivors, and underrepresentation of minority groups, and those with advanced cancer. Thus, this review highlights the need for further research to test tandem interventions against CBT alone and HL alone, and toward identifying the most efficacious interventions for dissemination and implementation across diverse groups of cancer survivors. Implications for cancer survivors Tandem CBT/HL interventions can improve health-related outcomes for cancer survivors when compared to usual care, but there is a paucity of knowledge to suggest differential outcomes when compared to CBT or HL alone.
Collapse
Affiliation(s)
- Sarah Addison
- The Ohio State College of Medicine, 370 West 9th Avenue, Columbus, OH 43210 USA
| | - Damalie Shirima
- The Ohio State University Comprehensive Cancer, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 460 W 10th Ave, Columbus, OH 43210 USA
| | | | - Shanon G. Dunovan
- College of Nursing, University of Nebraska Medical Center, 4111 Dewey Ave, Omaha, NE 68198 USA
| | - Esther Y. Pascal
- Department of Microbiology, College of Arts and Sciences, The Ohio State University, 281 W Lane Ave, Columbus, OH 43210 USA
| | - Maryam B. Lustberg
- The Ohio State University Comprehensive Cancer, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 460 W 10th Ave, Columbus, OH 43210 USA
- Department of Internal Medicine, Division of Medical Oncology, College of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210 USA
| | - Elizabeth K. Arthur
- The Ohio State University Comprehensive Cancer, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 460 W 10th Ave, Columbus, OH 43210 USA
- The Ohio State College of Nursing, 1585 Neil Avenue, Columbus, OH 43210 USA
| | - Timiya S. Nolan
- The Ohio State University Comprehensive Cancer, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, 460 W 10th Ave, Columbus, OH 43210 USA
- The Ohio State College of Nursing, 1585 Neil Avenue, Columbus, OH 43210 USA
| |
Collapse
|
7
|
Mujcic A, Blankers M, Boon B, Verdonck-de Leeuw IM, Smit F, van Laar M, Engels R. Effectiveness, Cost-effectiveness, and Cost-Utility of a Digital Smoking Cessation Intervention for Cancer Survivors: Health Economic Evaluation and Outcomes of a Pragmatic Randomized Controlled Trial. J Med Internet Res 2022; 24:e27588. [PMID: 35297777 PMCID: PMC9491833 DOI: 10.2196/27588] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/28/2021] [Accepted: 12/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background Smoking cessation (SC) interventions may contribute to better treatment outcomes and the general well-being of cancer survivors. Objective This study aims to evaluate the effectiveness, cost-effectiveness, and cost-utility of a digital interactive SC intervention compared with a noninteractive web-based information brochure for cancer survivors. Methods A health economic evaluation alongside a pragmatic 2-arm parallel-group randomized controlled trial was conducted with follow-ups at 3, 6, and 12 months. The study was conducted in the Netherlands over the internet from November 2016 to September 2019. The participants were Dutch adult smoking cancer survivors with the intention to quit smoking. In total, 165 participants were included and analyzed: 83 (50.3%) in the MyCourse group and 82 (49.7%) in the control group. In the intervention group, participants had access to a newly developed, digital, minimally guided SC intervention (MyCourse-Quit Smoking). Control group participants received a noninteractive web-based information brochure on SC. Both groups received unrestricted access to usual care. The primary outcome was self-reported 7-day smoking abstinence at the 6-month follow-up. Secondary outcomes were quality-adjusted life years gained, number of cigarettes smoked, nicotine dependence, and treatment satisfaction. For the health economic evaluation, intervention costs, health care costs, and costs stemming from productivity losses were assessed over a 12-month horizon. Results At the 6-month follow-up, the quit rates were 28% (23/83) and 26% (21/82) in the MyCourse and control groups, respectively (odds ratio 0.47, 95% CI 0.03-7.86; P=.60). In both groups, nicotine dependence scores were reduced at 12 months, and the number of smoked cigarettes was reduced by approximately half. The number of cigarettes decreased more over time, and the MyCourse group demonstrated a significantly greater reduction at the 12-month follow-up (incidence rate ratio 0.87; 95% CI 0.76-1.00; P=.04). Intervention costs were estimated at US $193 per participant for the MyCourse group and US $74 for the control group. The mean per-participant societal costs were US $25,329 (SD US $29,137) and US $21,836 (SD US $25,792), respectively. In the cost-utility analysis, MyCourse was not preferred over the control group from a societal perspective. With smoking behavior as the outcome, the MyCourse group led to marginally better results per reduced pack-year against higher societal costs, with a mean incremental cost-effectiveness ratio of US $52,067 (95% CI US $32,515-US $81,346). Conclusions At 6 months, there was no evidence of a differential effect on cessation rates; in both groups, approximately a quarter of the cancer survivors quit smoking and their number of cigarettes smoked was reduced by half. At 12 months, the MyCourse intervention led to a greater reduction in the number of smoked cigarettes, albeit at higher costs than for the control group. No evidence was found for a differential effect on quality-adjusted life years. Trial Registration The Netherlands Trial Register NTR6011; https://www.trialregister.nl/trial/5434 International Registered Report Identifier (IRRID) RR2-10.1186/s12885-018-4206-z
Collapse
Affiliation(s)
- Ajla Mujcic
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands.,Trimbos Institute, Utrecht, Netherlands
| | - Matthijs Blankers
- Trimbos Institute, Utrecht, Netherlands.,Department of Psychiatry, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, Netherlands.,Department of Research, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Brigitte Boon
- Academy het Dorp, Arnhem, Netherlands.,Siza, Arnhem, Netherlands.,Tranzo, Tilburg University, Tilburg, Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Center, Cancer Center Amsterdam, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Filip Smit
- Trimbos Institute, Utrecht, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Location VUmc, Amsterdam, Netherlands
| | | | - Rutger Engels
- Erasmus School of Social and Behavioural Sciences, Erasmus University, Rotterdam, Netherlands
| |
Collapse
|
8
|
Neumann M, Murphy N, Seetharamu N. Impact of Family and Social Network on Tobacco Cessation Amongst Cancer Patients. Cancer Control 2021; 28:10732748211056691. [PMID: 34798778 PMCID: PMC8606921 DOI: 10.1177/10732748211056691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Continued smoking after a cancer diagnosis adversely affects outcomes, including recurrence of the primary cancer and/or the development of second primary cancers. Despite this, prevalence of smoking is high in cancer survivors and higher in survivors of tobacco-related cancers. The diagnosis of cancer provides a teachable moment, and social networks, such as family, friends, and social groups, seem to play a significant role in smoking habits of cancer patients. Interventions that involve members of patients’ social network, especially those who also smoke, might improve tobacco cessation rates. Very few studies have been conducted to evaluate and target patients’ social networks. Yet, many studies have demonstrated that cancer survivors who received higher levels of social support were less likely to be current smokers. Clinicians should be doing as much as they can to encourage smoking cessation in both patients and relevant family members. Research aimed at influencing smoking behavioral change in the entire family is needed to increase cessation intervention success rate, which can ultimately improve the health and longevity of patients as well as their family members.
Collapse
Affiliation(s)
- Melissa Neumann
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Neal Murphy
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 5799Northwell Health Cancer Institute, Lake Success, NY, USA
| | - Nagashree Seetharamu
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 5799Northwell Health Cancer Institute, Lake Success, NY, USA
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Hirschey R, Nyrop KA, Mayer DK. Healthy Behaviors: Prevalence of Uptake Among Cancer Survivors. Clin J Oncol Nurs 2020; 24:19-29. [PMID: 32945809 DOI: 10.1188/20.cjon.s2.19-29] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although most cancer survivors adhere to recommendations to refrain from tobacco and minimize alcohol use, survivors of certain cancers are not meeting these recommendations. In addition, most cancer survivors do not achieve optimal recommendations for diet and physical activity, further decreasing survivor health and quality of life. Sun protective and sleep behaviors also tend to be suboptimal among survivors. Uptake of age-appropriate vaccinations is variable among survivors. OBJECTIVES The purpose of this article is to review the prevalence of healthy behavior uptake among cancer survivors and provide nurses with an overview of effective interventions, strategies, and resources to help patients improve these behaviors. METHODS An expert panel was convened to conduct an integrative review and synthesis on the state of the science of healthy behavior uptake among cancer survivors. FINDINGS Not meeting recommendations for healthy lifestyle behaviors increases the risk of second cancers and mortality and decreases overall health and quality of life. Healthy lifestyle behaviors can contribute to improved function, quality of life, and overall survival for cancer survivors. Nurses can help survivors to understand and improve their behaviors.
Collapse
|
11
|
Swoboda CM, Walker DM, Huerta TR. Likelihood of Smoking Among Cancer Survivors: An Updated Health Information National Trends Survey Analysis. Nicotine Tob Res 2020; 21:1636-1643. [PMID: 30843035 DOI: 10.1093/ntr/ntz007] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/14/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cancer survivors are at high risk for cancer reoccurrence, highlighting the importance of managing behavioral risk factors for cancer. Despite this risk, many cancer survivors continue to smoke cigarettes. This article describes the relationship between smoking behavior and demographic and clinical factors in cancer survivors. METHODS Multinomial logistic regression of cross-sectional data from the Health Information National Trends Survey was conducted using combined data from years 2003, 2005, 2007, 2011, 2012, 2013, and 2014. Independent variables included age, cancer history, race, education level, marital status, insurance status, and data year; the dependent variable was smoking status (current vs. former or never). RESULTS Cancer survivors were less likely to be current smokers but more likely to be former smokers than those with no history of cancer. Cancer survivors that currently smoked were more likely to have lower education levels, be divorced, separated, or single, or not have health insurance. Older cancer survivors, Hispanic, and non-Hispanic black survivors were less likely to smoke. Among cancer subgroups, prostate cancer survivors had the lowest rate (8.8%) of current smoking from 2011 to 2014, and cervical cancer survivors had the highest rate (31.1%). CONCLUSIONS Although those with no history of cancer had higher rates of current smoking, many subgroups of cancer survivors continued to smoke at higher rates than average cancer survivors. Cancer survivors that were younger, had lower education levels, were any marital status other than married or widowed, were uninsured, or survived cervical cancer were more likely to be smokers than other survivors. IMPLICATIONS It is important to understand which types of cancer survivors are at high risk of continued smoking to better inform tobacco dependence treatment interventions among those at high risk of cancer reoccurrence. Our findings suggest targeted tobacco dependence treatment efforts among cancer survivors should focus on survivors of cervical cancer and survivors that are young, unmarried, uninsured, or have lower education levels.
Collapse
Affiliation(s)
- Christine M Swoboda
- Department of Family Medicine, Ohio State University College of Medicine, Columbus, OH
| | - Daniel M Walker
- Department of Family Medicine, Ohio State University College of Medicine, Columbus, OH
| | - Timothy R Huerta
- Department of Family Medicine, Ohio State University College of Medicine, Columbus, OH.,Department of Biomedical Informatics, Ohio State University College of Medicine, Columbus, OH
| |
Collapse
|