Predictors of Smoking Relapse in Patients With Thoracic Cancer or Head and Neck Cancer

Cancer. 2013 Apr 1;119(7):1420-7. doi: 10.1002/cncr.27880. Epub 2012 Dec 20.

Abstract

Background: Cancer patients who continue smoking are at increased risk for adverse outcomes including reduced treatment efficacy and poorer survival rates. Many patients spontaneously quit smoking after diagnosis; however, relapse is understudied. The goal of this study was to evaluate smoking-related, affective, cognitive, and physical variables as predictors of smoking after surgical treatment among patients with lung cancer and head and neck cancer.

Methods: A longitudinal study was conducted with 154 patients (57% male) who recently quit smoking. Predictor variables were measured at baseline (ie, time of surgery); smoking behavior was assessed at 2, 4, 6, and 12 months after surgery. Analyses of 7-day point prevalence were performed using a Generalized Estimating Equations approach.

Results: Relapse rates varied significantly depending on presurgery smoking status. At 12 months after surgery, 60% of patients who smoked during the week prior to surgery had resumed smoking versus only 13% who were abstinent prior to surgery. Smoking rates among both groups were relatively stable across the 4 follow-ups. For patients smoking before surgery (N = 101), predictors of smoking relapse included lower quitting self-efficacy, higher depression proneness, and greater fears about cancer recurrence. For patients abstinent before surgery (N = 53), higher perceived difficulty quitting and lower cancer-related risk perceptions predicted smoking relapse.

Conclusions: Efforts to encourage early cessation at diagnosis, and increased smoking relapse-prevention efforts in the acute period following surgery, may promote long-term abstinence. Several modifiable variables are identified to target in future smoking relapse-prevention interventions for cancer patients.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Anxiety
  • Cognition
  • Depression
  • Female
  • Forecasting
  • Head and Neck Neoplasms / psychology*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Lung Neoplasms / psychology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Secondary Prevention*
  • Smoking
  • Smoking Cessation / psychology*