Implications of smoking for quality of life and illness perceptions of lung cancer patients.

6113 Background: Adverse publicity about smoking may lead to feelings of guilt among lung cancer patients or pessimism about their future, potentially compromising health-related quality of life (QoL) and adherence with medical advice. QoL is an important outcome in clinical trials, particularly where survival rates are low. We aim to compare QoL and illness perceptions of lung cancer patients depending on smoking history. Methods: Clinical data, measures of QoL (EORTC-QLQ-C30+LC13) and illness perceptions (Brief IPQ – includes items to assess perceived severity, causality, timeline, understanding, emotional impact, and control over illness) were completed by 190 newly diagnosed lung cancer patients (Non-small cell: 75%; Mean age: 68 years, range: 48-85 years; 58% males). Of these, 24% were current smokers, 69% former smokers, and 7% never smoked. Results: Although overall QoL was similar between the three smoker groups, there was a significant effect of smoking status on QoL subscale emotional function (EF)(F(2,168)=4.08,p=.019). Those who never smoked had significantly higher EF than current smokers (p=.03). There was also a significant effect of smoking history on cough (F(2,166);=5.40 ,p=.005) with smokers reporting significantly greater levels than former smokers (p=.004). Smokers were more likely than former smokers (p=.015) to attribute their lung cancer to smoking (F(2,161)=16.49,p<.000). Furthermore, there was a significant effect of smoking on the perceived timeline of illness (F(2,144)=3.33,p=.039), with smokers being more pessimistic about this than former smokers (p=.043). Conclusions: These findings have implications for planning the care of lung cancer patients. In addition to the different treatment needs of smokers and former smokers, smokers may need greater support to cope with the emotional effects of their illness. Our findings suggest that smokers blame their illness on their own behaviour, and have a more pessimistic view of likely survival time, so they may need more encouragement to accept life-prolonging treatments. These results may also inform tailored smoking-cessation advice.