Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis

• Published in: Journal of cancer survivorship Vol. 6; no. 3; pp. 333 - 344
• Main Authors: Underwood, J. Michael, Townsend, Julie S., Tai, Eric, White, Arica, Davis, Shane P., Fairley, Temeika L.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-09-2012; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Behavioral Risk Factor Surveillance System; Cancer; Female; Health behavior; Health Informatics; Health Promotion and Disease Prevention; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - diagnosis; Neoplasms - etiology; Neoplasms - psychology; Oncology; Prevalence; Primary Care Medicine; Prognosis; Public Health; Quality of Life Research; Risk factors; Smoking - adverse effects; Smoking - epidemiology; Smoking Prevention; Survivor; Survivors - psychology; Tobacco; Tobacco Use Disorder - epidemiology; Tobacco Use Disorder - etiology; Tobacco Use Disorder - psychology; Young Adult; Tobacco; Epidemiology; Second Primary; Neoplasms; Survivors
• ISSN: 1932-2259; 1932-2267
• DOI: 10.1007/s11764-012-0230-1

Introduction
People who continue to smoke after a cancer diagnosis have an increased risk for recurrences or development of new malignancies. These risks may be even higher among tobacco-related cancer survivors (TRCS). We describe tobacco use behaviors among TRCS, other cancer survivors, and people without a history of cancer.
Methods
We used 2009 Behavioral Risk Factor Surveillance System data to describe demographic characteristics, smoking history, current smoking prevalence, and smokeless tobacco use among TRCS, other cancer survivors, and people without a history of cancer (cigarette smoking and smokeless tobacco use were calculated after adjusting for age, sex, race, and insurance status). Tobacco-related cancers were defined as lung/bronchial, pharyngeal, laryngeal, esophageal, stomach, pancreatic, kidney/renal, urinary bladder, cervical, and acute myeloid leukemia.
Results
A total of 20 % of all cancer survivors were TRCS. TRCS were primarily female (68 %) and white (78 %). Smoking prevalence was higher among TRCS (27 %) compared with other cancer survivors (16 %) and respondents without a history of cancer (18 %). Smokeless tobacco use was higher among respondents without a history of cancer (4 %) compared with TRCS (3 %) and other cancer survivors (3 %).
Conclusions
The self-reported smoking prevalence among TRCS is higher than among other cancer survivors and people without a history of cancer. Targeted smoking prevention and cessation interventions are needed for cancer survivors, especially those diagnosed with a tobacco-related cancer.
Implications for cancer survivors
We recommend all cancer survivors be made aware of the health risks associated with smoking after a cancer diagnosis, and smoking cessation services be offered to those who currently smoke.
Condensed abstract
We provide the first population-based report on demographic characteristics and tobacco use behaviors among self-reported tobacco-related cancer survivors.