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

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Abstract

Purpose

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.

Methods

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.

Results

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).

Discussion

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.

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Acknowledgements

None.

Funding

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)].

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Authors and Affiliations

  1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia

    M. Shayne Gallaway, Sherri L. Stewart & Eric Tai

  2. Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA

    Bin Huang

  3. Kentucky Cancer Registry, College of Medicine, University of Kentucky, Lexington, KY, USA

    Bin Huang, Quan Chen, Thomas C. Tucker, Jaclyn K. McDowell & Eric Durbin

  4. Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA

    Thomas C. Tucker

  5. Division of Biomedical Informatics, College of Medicine, University of Kentucky, Lexington, KY, USA

    Eric Durbin

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  1. M. Shayne Gallaway
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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.

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Correspondence to M. Shayne Gallaway.

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Gallaway, M.S., Huang, B., Chen, Q. et al. Smoking and Smoking Cessation Among Persons with Tobacco- and Non-tobacco-Associated Cancers. J Community Health 44, 552–560 (2019). https://doi.org/10.1007/s10900-019-00622-z

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