Smoking and Smoking Cessation Among Persons with Tobacco- and Non-tobacco-Associated Cancers

  • M. Shayne GallawayEmail author
  • Bin Huang
  • Quan Chen
  • Thomas C. Tucker
  • Jaclyn K. McDowell
  • Eric Durbin
  • Sherri L. Stewart
  • Eric Tai
Original Paper



To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors.


Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007–2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. TACs included colorectal, pancreatic, and lung cancers; nTAC included breast, ovarian, and prostate cancers.


There were 10,033 TAC and 13,670 nTAC survivors. Smoking before diagnosis was significantly higher among TAC survivors (p < 0.0001). Among TAC survivors, smoking before diagnosis was significantly higher among persons who: were males (83%), aged 45–64 (83%), of unknown marital status (84%), had very low education (78%), had public insurance (89%), Medicaid (85%) or were uninsured (84%). Smoking cessation counseling and pharmacotherapy were more common among TAC than nTAC survivors (p < 0.01 and p = 0.05, respectively).


While smoking cessation counseling and pharmacotherapy were higher among TAC survivors, reducing smoking among all cancer survivors remains a priority, given cancer survivors are at increased risk for subsequent chronic diseases, including cancer. Tobacco cessation among all cancer survivors (not just those with TAC) can help improve prognosis, quality of life and reduce the risk of further disease. Health care providers can recommend for individual, group and telephone counseling and/or pharmacotherapy recommendations. These could also be included in survivorship care plans.


Smoking Smoking cessation Tobacco-associated cancers Health administrative claims Linkage Registry 




Author Contributions

MSG, ET: Conceptualization, methodology, formal analysis, investigation, writing original-draft, writing-review and editing, project administration. BH: Methodology, writing original-draft, writing-review and editing, resources, project administration. QC: Data analysis, writing original-draft, writing-review and editing. TCT, JKM, ED, SLS: Conceptualization, methodology, writing-review and editing, resources, project administration.


Funds to support this work were received from the Centers for Disease Control and Prevention [National Center for Chronic Disease Prevention and Health Promotion (U48DP0085014-01 SIP = 14-017)], and Markey Cancer Center Support Grant [Division of Cancer Prevention, National Cancer Institute (NCI P30 CA177558)].

Compliance with Ethical Standards

Conflict of Interest



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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Cancer Prevention and Control, Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and HealthAtlantaGeorgia
  2. 2.Department of Biostatistics, College of Public HealthUniversity of KentuckyLexingtonUSA
  3. 3.Kentucky Cancer Registry, College of MedicineUniversity of KentuckyLexingtonUSA
  4. 4.Department of Epidemiology, College of Public HealthUniversity of KentuckyLexingtonUSA
  5. 5.Division of Biomedical Informatics, College of MedicineUniversity of KentuckyLexingtonUSA

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