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Bokemeyer F, Lebherz L, Bokemeyer C, Gali K, Schulz H, Bleich C. Smoking patterns and the intention to quit in German cancer patients: a cross-sectional study. BMC Cancer 2024; 24:693. [PMID: 38844877 PMCID: PMC11155111 DOI: 10.1186/s12885-024-12380-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/14/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Continued smoking after a cancer diagnosis can be associated with lower treatment tolerance, poorer outcomes, and reduced quality of life compared to non-smoking cancer patients or to those who have quit. Yet about 60% of patients continue to smoke after being diagnosed and find it difficult to quit. To address this problem, it is necessary to identify current and past smoking patterns (e.g., frequency of use, types of tobacco products) and determine whether there is motivation to quit. Similarly, factors associated with continued smoking should be identified. These data will provide the basis for the development of smoking cessation programs tailored to the needs of cancer patients. METHODS A questionnaire was distributed to cancer patients older than 18 years in a German Comprehensive Cancer Center. Participating cancer patients were divided into three main groups: 1) patients who stopped smoking before being diagnosed with cancer (Ex-before); 2) patients who stopped smoking after a cancer diagnosis (Ex-after); and 3) patients who currently smoke cigarettes (CS). Sociodemographic, medical, and psychosocial data were collected, as well as smoking patterns and the motivation to quit smoking. RESULTS About half of patients (51%) who smoked before diagnosis continue to smoke after a cancer diagnosis. Being diagnosed with a tobacco-related cancer type was associated with a decreased probability of continued smoking. Patients with tobacco-related tumors and receiving positive support in burdensome situations were more likely to have a higher cigarette dependence. Of all CS, 59.1% had intention to quit, and 22.7% reported having taken action to quit. The support by a smoking cessation program was considered important. CS were willing to spend up to €100 for support and were open to multiple sessions per week, group sessions, one-on-one sessions and/or online support. CONCLUSION These findings underscore the importance of educating cancer patients about the consequences of smoking and to provide them with support to quit. Identified risk factors may further help to recognize cancer patients with high risk of continued smoking after diagnosis. TRIAL REGISTRATION The study was registered at OSF ( https://osf.io/3c9km ) and published as a study protocol at " https://bmjopen.bmj.com/content/13/4/e069570 ".
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Affiliation(s)
- Frederike Bokemeyer
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
- Center for Oncology, II. Medical Clinic and Polyclinic, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Lisa Lebherz
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Carsten Bokemeyer
- Center for Oncology, II. Medical Clinic and Polyclinic, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Kathleen Gali
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Hamburg Center for Health Economics (HCHE), University of Hamburg, Esplanade 36, 20354, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Center Hamburg Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Bokemeyer F, Lebherz L, Schulz H, Bokemeyer C, Gali K, Bleich C. Smoking patterns and the intention to quit in German patients with cancer: study protocol for a cross-sectional observational study. BMJ Open 2023; 13:e069570. [PMID: 37055212 PMCID: PMC10106069 DOI: 10.1136/bmjopen-2022-069570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023] Open
Abstract
INTRODUCTION Patients who continue to smoke cigarettes after a cancer diagnosis can experience poorer treatment tolerance and outcomes than those who quit immediately. Identifying risk factors specific to patients with cancer who smoke, as well as their smoking behaviours (eg, frequency of use, types of tobacco products), dependency level and quit intentions, is necessary to better inform patients and encourage quitting smoking after a cancer diagnosis. This study aims to examine the occurrence of smoking in patients with cancer treated at specialised oncology departments and outpatient clinics based within the metropolitan region of Hamburg, Germany, and presents an analysis of their smoking patterns. This understanding is the first step in developing an adequate smoking cessation intervention and shall contribute to a sustainable improvement in the treatment results, long-term survival and quality of life of patients with cancer. METHODS AND ANALYSIS A questionnaire will be administered to patients with cancer (N=865) aged 18 years and above in the catchment area of Hamburg, Germany. Data acquisition includes sociodemographic, medical and psychosocial data as well as information on current smoking patterns. To identify the associations between smoking patterns and sociodemographic characteristics, disease-related variables, and psychological risk factors, descriptive statistics and multiple logistic as well as multinomial regressions will be performed. ETHICS AND DISSEMINATION This study was registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/PGBY8). It was approved by the ethics committee of the local psychological Ethic committee at the centre of psychosocial medicine Hamburg, Germany (LPEK) (tracking number: LPEK-0212). The study will be carried out in accordance with the Code of Ethics of the Declaration of Helsinki. The results will be published in peer-reviewed scientific journals.
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Affiliation(s)
- Frederike Bokemeyer
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- II. Medical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lisa Lebherz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Holger Schulz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carsten Bokemeyer
- II. Medical Clinic and Polyclinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kathleen Gali
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Hamburg Center for Health Economics, Universität Hamburg, Hamburg, Germany
| | - Christiane Bleich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Dotlic J, Markovic N, Gazibara T. Patterns of smoking and menopause-specific quality of life: smoking duration matters more. Behav Med 2023; 49:29-39. [PMID: 34818993 DOI: 10.1080/08964289.2021.1958739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Evidence about the association of quantity of cigarettes smoked and duration of smoking with quality of life in menopause is sparse. The purpose of this study was to examine the association between smoking patterns and menopause-specific quality of life. This cross-sectional study included 513 consecutive midlife women at two primary health care centers in Belgrade, Serbia. Collection of data was carried out from February 2014 to January 2015, using three questionnaires: socio-epidemiologic questionnaire, Menopause-specific Quality of Life questionnaire (MENQOL) and Beck's Depression Inventory (BDI). Women reported their smoking status (smoker, former smoker, non-smoker), the length of time spent smoking and quantity of cigarettes smoked per day. There was no difference in proportions of ever smokers compared to never smokers. However, there were more women who were current nonsmokers than current smokers. A linear regression model, adjusted for residency district, relationship status, educational level, employment, drinking alcohol, having exercise, age and BDI, showed that longer duration of smoking, but not number of cigarettes smoked per day, was associated with worse Physical domain and total MENQOL score. Receiver Operating Characteristic analysis showed that menopausal symptoms as measured by total MENQOL score were significantly less bothersome for women who smoked less than 10 years and significantly more intense in women who smoked 21 to 30 years. Midlife women should be encouraged to quit smoking as soon as possible, preferably before menopause. Strategies to prevent and quit smoking should be prioritized at all levels of health care delivery for women.Supplemental data for this article is available online at.
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Affiliation(s)
- Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Tatjana Gazibara
- Institute for Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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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.
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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
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Smoking Cessation Intention and Its Association with Advice to Quit from Significant Others and Medical Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062899. [PMID: 33809014 PMCID: PMC8000726 DOI: 10.3390/ijerph18062899] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/25/2022]
Abstract
Few studies have simultaneously considered the effects of significant others and medical professionals’ advice to quit smoking on smoking cessation intention. The present study involved 3841 current adult Korean smokers, divided into four groups with an intention to quit within 1 month, within 6 months, someday, and without intention to quit. Multinomial multiple logistic regression analysis was conducted according to smoking cessation intention level, adjusted for potential confounders, including past smoking cessation attempts. Smokers who had been advised to quit smoking by both significant others and medical professionals, significant others only, and medical professionals only were 2.63 (95% confidence interval (CI): 1.62–4.29), 1.84 (95% CI: 1.17–2.89), and 1.44 (95% CI: 0.70–2.94) times more likely to intend to quit within 1 month, respectively, than those who were not advised to quit. The odds ratios of an intention to quit within 6 months were 2.91 (95% CI: 1.87–4.54), 2.49 (95% CI: 1.69–3.68), and 0.94 (95% CI: 0.44–2.05), respectively. To promote smokers’ intention to quit, the role of significant others should be considered. Medical professionals’ advice to quit smoking remains important, increasing the effects of significant others’ advice.
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Dieleman LA, van Peet PG, Vos HMM. Gender differences within the barriers to smoking cessation and the preferences for interventions in primary care a qualitative study using focus groups in The Hague, The Netherlands. BMJ Open 2021; 11:e042623. [PMID: 33514579 PMCID: PMC7849885 DOI: 10.1136/bmjopen-2020-042623] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/21/2020] [Accepted: 01/13/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This research aimed to provide a deeper insight into the gender-specific barriers to smoking cessation and gender-specific preferences for interventions in primary care, in order to contribute to better aligned cessation care for women. DESIGN Qualitative study using focus groups. SETTING Regularly smoking female and male adults were recruited from four different general practices in The Hague (The Netherlands). PARTICIPANTS A total of 11 women and nine men participated. Participants included were regular smokers with a minimum age of 18 and sufficient command of the Dutch language, who were willing to talk about smoking cessation. Inclusion ended when saturation was reached for both women and men. Participants were selected by means of purposeful sampling, whereby looking at age, educational level and experience with quitting. RESULTS The main barriers to smoking cessation in women were psychological factors, such as emotion and stress, compared with environmental factors in men. Women indicated they were in need of support and positivity, and both women and men expressed the desire for assistance without judgement. Contrary to men, women were not drawn to restrictions and (dis)incentives. CONCLUSION When counselling smokers, in women the focus should be on perceived internal problems, as opposed to more external obstacles in men. Contrary to men, female smokers seem to prefer non-coercive interventions, such as a group intervention offering support and positivity. Future research should focus on these gender differences, and how they could improve treatment in primary care.
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Affiliation(s)
| | - Petra G van Peet
- Department of Public Health and Primary Care, LUMC, Leiden, The Netherlands
| | - Hedwig M M Vos
- Department of Public Health and Primary Care, LUMC, Leiden, The Netherlands
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Mederos N, Friedlaender A, Peters S, Addeo A. Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer. ESMO Open 2020; 5:e000796. [PMID: 33148544 PMCID: PMC7643520 DOI: 10.1136/esmoopen-2020-000796] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/05/2020] [Accepted: 09/12/2020] [Indexed: 12/13/2022] Open
Abstract
Lung cancer remains the leading cause of cancer-related deaths worldwide in women and men. In incidence, lung cancer ranks second, surpassed by breast cancer in women and prostate cancer in men. However, the historical differences in mortality and incidence rate between both sexes have changed in the last years. In the last decades, we have also witnessed an increased number of lung cancer in female never-smokers. These disparities have grown our interest in studying the impact of the gender and sex in the presentation of lung cancer. The aetiology is yet to be fully elucidated, but the data are clear so far: there is a growing divide between lung cancer presentation in women and men that will change our management and study of lung cancer. This article aims to review the sex and gender differences in lung cancer.
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Affiliation(s)
- Nuria Mederos
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Alex Friedlaender
- Department of Oncology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alfredo Addeo
- Department of Oncology, Hopitaux Universitaires de Geneve, Geneva, Switzerland
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