Blog | Wednesday, January 25, 2012

QD: News Every Day--Get cancer, keep smoking, what does it take to quit?


Patients continue to smoke after their diagnosis, including nearly one in seven lung cancer patients, a study found.

Because CT scanning is becoming more prevalent for lung cancer screening, and earlier detection could lead to less mortality, the issue of smoking cessation will become even more important in the future, the authors suggested in their research.

The research was a cohort of more than 10,000 patients in the multi-regional Cancer Care Outcomes Research and Surveillance cohort, of which lung cancer comprises 2,456 people and colorectal cancer 3,063. Results appeared in Cancer.

At diagnosis, 38.7% of patients with lung cancer and 13.7% of patients with colorectal cancer were smoking. Five months after the diagnosis, 14.2% of patients with lung cancer and 9% of patients with colorectal cancer were still smoking. This means that slightly less than two-thirds (63%) of lung cancer patients and slightly more than one-third (34.3%) of patients with colorectal cancer who had been smoking around the time of diagnosis had quit five months later, researchers noted.

Factors that were associated with lung cancer patients continuing to smoke included being unmarried, using public insurance over private insurance, not undergoing surgery, having more lung cancer symptoms, having a history of cardiovascular disease or lung disease, reporting worse pain in the past month, having a lower body-mass index, having more depression, and having a greater highest reported number of cigarettes smoked per day (all P less than .05).

Significant factors associated with continued smoking among patients with colorectal cancer were white race/ethnicity, older age, not undergoing surgery, not receiving chemotherapy, reporting higher levels of depression, and having a greater highest reported number of cigarettes per day (all P less than .05)

Authors also noted that two factors were associated significantly with continued smoking in both groups: not undergoing surgery and the highest number of cigarettes ever smoked per day. Because of the negative effects of smoking on wound healing, many surgeons insist on abstinence from cigarettes before surgery, which may reduce treatment complications and boost efficacy. Smoking more cigarettes per day could be proxy for addiction, and underscores the need for pharmacologic support to stop smoking.

"Because of the widespread public knowledge that smoking causes lung cancer, it is plausible that patients with lung cancer associate their diagnosis with smoking and quit accordingly, whereas patients with colorectal cancer may not associate their diagnosis with smoking and, thus, may be less likely to change their smoking behavior as a result of their diagnosis," the authors wrote. "Another possibility is that oncology providers are more likely to talk to patients with lung cancer about quitting."