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Study examines cancer patientsí smoking addictions

Sunday January 27, 2013
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In a study, patients who had lung cancer or head and neck cancer and who smoked before surgery were more likely to relapse than those who had quit before surgery, according to a study.

Smoking-relapse prevention interventions are needed immediately after surgery to help prevent relapse, according to researchers with Moffitt Cancer Center in Tampa, Fla.

"Cigarette smoking is responsible for 30% of all cancer-related mortalities," study corresponding author Vani Nath Simmons, PhD, assistant member of the Health Outcomes and Behavior Program at Moffitt, said in a news release. "Head and neck and lung cancers are the most strongly linked to tobacco use. Many patients with these cancers make an attempt to quit smoking at the time of diagnosis. However, little attention has been paid to looking at how successful patients are at quitting and what predicts who is likely to resume smoking.

"This is particularly a concern for cancer patients because continued smoking can be related to cancer recurrence, cancer treatment complications, second primary tumors and poorer quality of life."

The goal of the study was to examine smoking trajectories among lung and head and neck cancer patients for 12 months after surgery and to test potential predictors of smoking relapse. "Only a few studies have examined factors associated with smoking relapse among patients with head and neck cancer or lung cancer, and this information is needed to develop smoking-relapse prevention interventions for this population," said study co-author Thomas H. Brandon, PhD, director of the Tobacco Research and Intervention Program at Moffitt.

Study participants were recruited from clinics at Moffitt. Patients either had quit smoking shortly before or immediately after surgery. Smoking behavior was assessed at two, four, six and 12 months after surgery.

"We found that relapse rates varied significantly depending on a patientís pre-surgery smoking status," Simmons said, with 60% of patients who smoked during the week prior to surgery resuming smoking afterward. In contrast, those who quit smoking before surgery had a 13% relapse rate.

Given the significantly lower relapse rates among those who quit smoking prior to surgery, smoking cessation should be encouraged at diagnosis, the researchers said. Because most relapses occurred shortly after surgery, they noted, smoking cessation assistance is important before and after surgery

The researchers also found that factors such as high fears regarding cancer recurrence, greater susceptibility to depression and less belief in their ability to quit smoking predicted smoking relapse.

"Cancer patients are highly motivated to quit, so receiving a cancer diagnosis can be viewed as a 'teachable momentí for delivering smoking cessation and relapse prevention interventions," Brandon said.

"Cancer patients need to know that itís never too late to quit," Simmons said. "Of course, it would be best if they quit smoking before getting cancer, but barring that, they should quit as soon as they get diagnosed. And with a little assistance, there is no reason that they canít succeed."

The study is scheduled for publication in the journal Cancer. The study abstract is available at http://onlinelibrary.wiley.com/doi/10.1002/cncr.27880/abstract.


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