Abstract
Background This study investigated the smoking behaviours and cessation rates of head and neck cancer patients and explored the barriers and facilitators to cessation. Methods A mixed methods sequential explanatory design was utilised. The quantitative data was collected through surveys prior to treatment commencement. The current smokers were followed up after treatment to determine their smoking status. One-on-one, semi-structured interviews were then conducted. Results A total of 64 participants were recruited. Participants who were current smokers were more likely to live in a rural location (p = 0.015), have lower education (p = 0.047), and report reduced social and family well-being (p = 0.005) when compared with those who were former or never smokers. The 7-day point prevalence cessation rate was 72% at 1-month follow-up and 67% at 3 months, while continuous smoking cessation was 54% at 1 month and 42% at 3 months. Participants who continued smoking were found to consume more alcohol (p = 0.032) and have higher psychological distress (p = 0.052). Qualitative analysis revealed 5 key themes associated with smoking cessation: the teachable moment of a cancer diagnosis and treatment, willpower and cessation aids, psychosocial environment, relationship with alcohol and marijuana, and health knowledge and beliefs surrounding smoking and cancer. Conclusion This study demonstrates that the majority of head and neck cancer patients are able to achieve smoking cessation, but relapses are common. Future cessation programs should be comprehensive, sustained and address co-morbid factors such as alcohol, marijuana and depression.
Diagnostic delay for head and neck cancer in South India: A Mixed-methods Study.
