A new study out Wednesday finds that nearly 10 percent of cancer survivors continue to smoke despite risks to their health. The study was published in the journal Cancer Epidemiology, Biomarkers and Prevention.
The study was conducted by the American Cancer Society and surveyed nearly 3,000 patients nine years after their diagnosis. Participating patients suffered from the ten most common types of cancer: breast, prostate, melanoma, uterine, kidney, colorectal, ovarian, lung, and Non-Hodgkin lymphoma. Results of the study found that 9.3 percent of patients continued to smoke, with 83 percent smoking every day. Those who smoked every day averaged nearly 15 cigarettes per day.
The highest incidence of smokers were patients who suffered from bladder cancers, 17.2 percent, and lung, 14.9 percent, which are both types of cancer caused by smoking. Smoking decreases the effectiveness of cancer treatment, increases likelihood of recurrence, and reduces survival rates. Lower rates of smoking were found among cancer patients with melanoma, 7.6 percent, and colorectal cancers, 6.8 percent.
This is the first study to measure patients and their smoking habits after cancer treatment. Lee Westmaas, lead author of the study and researcher for the American Cancer Society, says it was not known what happened to the people and whether or not they went back to smoking after treatment. Armed with this new data, he says, “Quitting is the single best thing” a person can do to improve their health and increase their chance of survival after cancer.
Dr. Norman Edelman, senior medical advisor at the American Lung Association, was not surprised by the findings. It is consistent with what he sees in clinical practice. With survivors of cancer, he says, the problem is convincing them there is a point in quitting. But he is quick to point out that quitting is beneficial. “Smoking can kill you in a lot of ways,” he says. Quitting, meanwhile, lowers the odds of recurrence along with chances of emphysema and heart disease. He acknowledges how hard it is to quit, saying, “Rarely do people quit on the first try.”
Of cancer survivors who continue to smoke, less than half, 47 percent, planned to quit. Ten percent surveyed had no plans to quit. Forty-three percent were unsure. Many of the smokers without intent to quit were older in age, suggesting a belief that life expectancy would not be improved by quitting. Smokers tended to be female rather than male, and largely uneducated and have low incomes. Smoking was also more prevalent among those who had a recurrence of cancer and drank more alcohol.
Authors of the study define this as an area of improvement for doctors to work with patients. Westmaas says the data found in the study indicates the level of addiction occurring and “just how difficult it is to quit.” Many hospitals have smoking cessation programs for cancer patients that include behavioral counseling, medication, and nicotine replacement therapy, but Roy Herbst, chief medical oncologist at Yale University, says, “Clearly we need to do better.”
“Smoking is addictive,” Westmaas cautioned. Just because a patient has cancer does not mean they can quit. He added, “Lack of knowledge about available treatments” is an issue. Increasing access to cessation programs and informing cancer survivors about options for quitting would give those who continue to smoke a way to quit.
By Stacey Wagner