Smoking cessation among men following cancer diagnosis: a matched cohort study
Cigarette smoking among cancer survivors increases the risk of recurrence and secondary cancers. We sought to investigate smoking cessation following diagnosis of cancer compared to those not diagnosed with cancer. We also investigated cessation following diagnosis of a smoking-related and non-smoking-related cancer separately.
We conducted a matched cohort study within the Health Professionals Follow-Up Study (HPFS). We identified 566 men diagnosed with cancer who were current cigarette smokers at the time of diagnosis between 1986 and 2010 (exposed). Men diagnosed with cancer were age-matched 1:4 to men without a diagnosis of cancer who were also current cigarette smokers (unexposed). Multivariable conditional logistic regression models were used to calculate odds ratios (OR) and 95% confidence intervals (CI) to evaluate the association between a cancer diagnosis and smoking cessation within 2 and 4 years post diagnosis adjusted for potential confounders, overall and for smoking-related and non-smoking-related cancers.
Of the men with cancer, 38% quit within 2 years and 42% within 4 years of diagnosis. Men diagnosed with cancer were more likely to quit smoking within 2 (OR = 2.5, 95% CI: 2.0–3.0) and 4 years (OR = 1.6, 95% CI: 1.3–2.0) post diagnosis, compared to matched men without cancer. The association was similar for smoking-related (OR = 3.4, 95%: 1.6–7.2) and non-smoking-related cancers (OR = 3.8, 95%: 2.8–5.2).
Men diagnosed with cancer were more likely to quit smoking compared to men not diagnosed with cancer. A cancer diagnosis may be a “teachable moment” in which strategies to promote smoking cessation for individuals diagnosed with smoking-related and non-smoking-related cancers should be investigated.
Implications for Cancer Survivors
There is a continued need for the widespread implementation of cessation interventions for cancer survivors.
KeywordsSurvivors Cessation Prevention Smoking-caused diseases
We are grateful to the ongoing participation of the men in the Health Professionals Follow-Up Study.
Role of the sponsor
The funding agencies had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.
The HPFS is supported by funding from the National Cancer Institute at the National Institutes of Health (UM1 CA133891). CDR is supported by the National Cancer Institute Cancer Prevention Fellowship Program. SCM is supported by the National Cancer Institute at the National Institutes of Health Training Grant NIH T32 CA09001and NIH P50 CA090381-15. LAM is supported by the Prostate Cancer Foundation.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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