Does a Recent Cancer Diagnosis Predict Smoking Cessation? An Analysis From a Large Prospective US Cohort

Abstract

Purpose Quitting smoking provides important health benefits to patients with cancer. A cancer diagnosis may motivate quitting—potentially providing a teachable moment in which oncologists can encourage and assist patients to quit—but little is known about whether a recent cancer diagnosis (including diagnosis of a cancer that is less strongly linked to smoking) is associated with increased quitting. Methods Cancer Prevention Study-II Nutrition Cohort participants reported smoking status at enrollment in 1992 to 1993 and approximately biennially through 2009. Quit rates of smokers diagnosed with cancer during 2- and 4-year intervals were compared with those of smokers not diagnosed with cancer (12,182 and 12,538 smokers in 2- and 4-year analyses, respectively). Cancers likely to cause physical limitations or symptoms that could influence smoking (cancers of the lung, head and neck, esophagus, or any metastatic cancer) were excluded. Logistic regressions calculated quit rates controlling for age, sex, survey year, cardiovascular disease, and chronic obstructive pulmonary disease. Results The 2-year quit rate was higher among the 772 smokers who were diagnosed with cancer (31.3%; 95% CI, 28.0% to 34.5%) than among smokers not diagnosed with cancer (19.5%; 95% CI, 19.0% to 19.9%). A similar difference was observed for 4-year quit rates (43.0% v 33.8%). Results were similar by cancer site and stage. Conclusion A diagnosis of cancer, even a cancer not strongly related to smoking and with a relatively good prognosis, may be associated with increased quitting that is sustained well after diagnosis. Results support the hypothesis that a cancer diagnosis presents a teachable moment that can be capitalized on to promote cessation.