Perception of Effects of Continued Smoking Among Patients With Cancer


Key Points

  • Current smokers were less likely to believe that continued smoking is harmful.
  • Among current smokers, greater belief in harm of continued smoking was associated with subsequent quitting. 

In a study reported in the Journal of Oncology Practice, Alton et al found that current cigarette smokers were less likely to believe that continued smoking after cancer diagnosis was harmful compared with ex-smokers or never-smokers. Continued smoking after cancer diagnosis has been associated with poorer treatment outcome, survival, and quality of life.

Study Details

The study involved a survey of patients with cancer of all types at Princess Margaret Cancer Centre between April 2014 and May 2016. Among 1,121 recruited patients, 261 (23%) smoked in the year before diagnosis (current smokers), 44% were never-smokers, and 33% were ex-smokers (quit ≥ 1 year before diagnosis). Of the 261 current smokers, 142 (54%) quit smoking by the time of study recruitment; median time from diagnosis to study recruitment was 18.5 months. Overall, 27% of patients had primary head and neck cancers and 23% had lung cancer.

Perceptions of Continued Smoking

Overall, the majority of all patients indicated the belief that smoking after a cancer diagnosis negatively affected quality of life (83%), survival (86%), and fatigue (82%). Current smokers vs ex-smokers and never-smokers were less likely to believe that continued smoking was harmful in terms of quality of life (68% vs 86% and 89%), survival (72% vs 88% and 92%), and fatigue (69% vs 86% and 87%; all P < .001).

Among current smokers, the perceptions that smoking negatively affected quality of life (adjusted odds ratio [aOR] = 2.68, P = .011), survival (aOR = 5.00, P < .001), and fatigue (aOR = 3.57, P < .001) were significantly associated with smoking cessation between diagnosis and study recruitment. Greater smoking history was associated with lower likelihood of believing that smoking was harmful in terms of quality of life (aOR = 0.98, P < .001), survival (aOR = 0.98, P < .001), and fatigue (aOR = 0.99, P < .001).

The investigators concluded, “The perceptions of continued smoking after a cancer diagnosis among patients with cancer are strongly associated with smoking cessation. Counseling about the harms of continued smoking in patients with cancer, and in particular among those who have lower risk perceptions, should be considered when developing a smoking cessation program.”

Meredith E. Giuliani, MBBS, Department of Radiation Oncology, Princess Margaret Cancer Centre, is the corresponding author for the Journal of Oncology Practice article. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.