Smoking Cessation: An Essential Component in the Treatment of Lung Cancer Patients

75 Background: Smoking during cancer treatment negatively impacts outcome, survival, and quality of life. Social smoking environments (SSEs) (i.e., smoking in household, peers, and spouse) influence cessation rates in non-cancer patients, but are understudied in cancer patients. Methods: Lung cancer patients, recruited from Princess Margaret Hospital (2006-2012) were given baseline and follow-up questionnaires (median of 2 years apart) evaluating changes in smoking habits and SSEs. Multivariate logistic regression and Cox-proportional hazard models evaluated the association of socio-demographics, clinicopathological and SSE factors with smoking cessation and time to quitting, respectively. Results: 721 patients completed both questionnaires. Of the 261 current smokers at diagnosis, 180 (69%) had quit by follow-up. Among 318 ex-smokers, 5 re-started smoking after diagnosis. All of the 140 never smokers remained non-smoking. Home smoke exposure (OR=9.4; 95% CI: 3.4-26.2; p=2.0 x 10E-5), spousal smoking (OR=4.7, 95% CI:1.7-12.6; p=3.0 x 10E-3) and peer smoking (OR=2.6; 95% CI:1.1-6.1; p=0.03) were each associated with reduced cessation, adjusted for a base multivariate model that included education and past history of depression. Individuals with no SSE factors had a much higher chance of quitting smoking when compared to patients with multiple areas of SSEs (0 vs. 3, OR=16.4; 95% CI: 4.1-66.7; p=7.3 x 10E-5). Similar results were seen when using time-to-quitting as the outcome (0 vs 3, OR=4.4, 95% CI=1.4-14.1, p=0.01). Time to quitting analysis found that 60% of patients with at least one SSE who did quit, did so within 6 months of diagnosis. Subgroup analysis revealed similar associations in early- and late-stage patient groups. Conclusions: SSE is a key factor in smoking cessation, where household smoke exposures reduces the chance of quitting up to 9-fold. SSEs should be a key consideration when developing smoking cessation programs in lung cancer patients, as part of quality improvement strategies. Approaches incorporating household members or spouses into the smoking cessation intervention, around the time of diagnosis, should be researched further. GL and WX are co-senior authors.

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144 Smoking cessation advice and help for lung cancer patients – an audit of current practice

Lung Cancer ◽

10.1016/s0169-5002(13)70144-2 ◽

2013 ◽

Vol 79 ◽

pp. S49 ◽

Cited By ~ 1

Author(s):

L. Eng ◽

L. Lee

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Patients ◽

Current Practice ◽

Smoking Cessation Advice ◽

Lung Cancer Patients

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I.9 Importance of Smoking Cessation in the Treatment of Lung Cancer Patients

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.09.103 ◽

2019 ◽

Vol 14 (11) ◽

pp. S1159

Author(s):

C. Dresler

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Cancer Patients ◽

Lung Cancer Patients

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Assessment of the Impact of Adjunctive Proactive Telephone Counseling to Promote Smoking Cessation among Lung Cancer Patients' Social Networks

American Journal of Health Promotion ◽

10.4278/ajhp.101122-quan-387 ◽

2013 ◽

Vol 27 (3) ◽

pp. 181-190 ◽

Cited By ~ 15

Author(s):

Lori A. Bastian ◽

Laura J. Fish ◽

Bercedis L. Peterson ◽

Andrea K. Biddle ◽

Jennifer Garst ◽

...

Keyword(s):

Lung Cancer ◽

Smoking Cessation ◽

Social Network ◽

Cancer Patients ◽

Coping Skills ◽

Telephone Counseling ◽

Adaptive Coping ◽

Lung Cancer Patients ◽

Nicotine Patches ◽

The Impact

Purpose. When a patient is diagnosed with lung cancer, members of his/her social network may be more likely to engage in smoking cessation efforts. Proactive telephone counseling combined with a tailored self-directed intervention may be more effective at promoting smoking cessation than a tailored self-directed intervention alone. Design. Randomized controlled trial. Setting. Four clinical sites. Subjects. Current smokers who are family members and close friends of patients with lung cancer. Intervention. Six counselor-initiated counseling calls using motivational interviewing techniques and focusing on teaching adaptive coping skills based on the transactional model of stress and coping along with tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 245) vs. tailored self-directed materials (including nicotine patches, if not contraindicated) (n = 251). Measures. Participants were surveyed at baseline and at 2 weeks, 6 months, and 12 months postintervention. The outcome was 7-day point prevalent abstinence. Analysis. The objective of this study was to test for arm differences in smoking cessation rates at 2 weeks and 6 months postintervention (primary) and at 12 months postintervention (secondary). Results. We found no overall effect of the proactive intervention on cessation rates. Among younger participants (age <50), the cessation rate in the intervention group was higher than in the control group at 2 weeks postintervention (16% vs. 4%, p = .046). For older participants (age >50), there were no group differences. Conclusion. Proactive telephone counseling focusing on adaptive coping skills was difficult to implement among smokers in lung cancer patients' social network. Although this study did not demonstrate any added benefit to cessation rates, this null finding may be a result of an intervention that was weaker than intended, owing to difficulties in completing the counseling phone calls. We discuss lessons learned and areas for future research in this special population.

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