Nearly one in ten cancer survivors reports smoking many years after a diagnosis, according to a new study by American Cancer Society researchers. Further, among ten cancer sites included in the analysis, the highest rates of smoking were in bladder and lung cancers, two sites strongly associated with smoking. The study appears online in Cancer Epidemiology, Biomarkers & Prevention.

Makes a recurrence more likely

Cigarette smoking decreases the effectiveness of cancer treatments, increases the probability of recurrence, and reduces survival time. Nonetheless, some studies show a significant proportion of cancer survivors continue to smoke after being diagnosed. Most of those studies cover a relatively short time period. There remains a lack of information on smoking prevalence for survivors many years after diagnosis.

To help close that gap, researchers led by Lee Westmaas, PhD, looked at survey responses from nearly three thousand cancer survivors in the American Cancer Society’s Study of Cancer Survivors–I (SCS-I), a longitudinal nationwide study of adult cancer survivors. The study was limited to those with one of the 10 most highly incident cancers at the time of enrollment (breast, prostate, bladder, uterine, melanoma, colorectal, kidney, Non-Hodgkin Lymphoma, ovarian, and lung).

Interviewed about nine years after diagnosis, 9.3% of the survivors reported being current smokers, 41.2% were former smokers, and 49.6% were never smokers. Among current smokers, 83.1% smoked every day. Nearly half (46.6%) indicated they planned to quit, while 10.1% did not and 43.3% were not sure. Of the 1,209 former smokers, 88.6% had quit before their diagnosis.

An unexpected finding among married smokers

Several sociodemographic variables were associated with current smoking status. Survivors who were younger, female, had lower education, and lower income were most likely to remain smokers. The study also found that married smokers had lower intentions of quitting, an unexpected finding that the researchers say has not been previously reported.

“Effective cessation treatment for cancer survivors exists,” write the authors, “but future population-based studies examining the importance of psychosocial variables, and their relationships to other health-related variables in predicting current smoking or motivation to quit, will further contribute to enhancing cessation strategies for all survivors who smoke.”

Some may need more intense treatment

The authors conclude that “Those who smoke heavily long after their diagnosis may require more intense treatment addressing specific psychosocial characteristics such as perceptions of risk, beliefs of fatalism, etc. that may influence motivation to quit.”

Article: Prevalence and Correlates of Smoking and Cessation-Related Behavior among Survivors of Ten Cancers: Findings from a Nation-Wide Survey Nine Years after Diagnosis, Cancer Epidemiol Biomarkers Prev, Published online Aug  6, 2014 doi: 10.1158/1055-9965.EPI-14-0046