Smoking and Cancer: A Population-based Study

Smoking is a major risk factor among the growing number of cancer survivors. Studies show that continuing to smoke as a cancer survivor adversely impacts prognosis and survival. We examined smoking prevalence among cancer survivors and compared the demographic profiles of current smokers among individuals with and without a history of cancer. The National Health and Nutrition Examination Survey 1999-2004 with 1,384 cancer survivors and 13,923 non-cancer individuals was used. All analyses were weighted to represent the United States population. The overall current smoking rate in the cancer group was significantly lower than the non-cancer group (19.2% vs. 25.3%). After stratifying by age, the current smoking rate of the cancer population compared to the non-cancer population is significantly higher before age 40 (45.6% vs.30.2%) and is significantly lower after age 70 (5.4% vs. 8.2%). We observed that the current smoking rates decreased as age increased in both cancer and non-cancer populations but a steep decline was observed in cancer survivors. Among cancer survivors, males had a significantly lower smoking rate than females (14.1% vs. 22.8%); however, this gender difference is primarily due to a different age distribution across males and females. Study results suggest that among cancer survivors, sociodemographic characteristics are associated with continued smoking. Interventions for cancer survivors should target whites, poorer, widowed, divorced or separated, and those with less education. Efforts to encourage smoking cessation among younger cancer survivors are indicated. In addition, developing smoking cessation programs for cervical, melanoma and breast cancer survivors is of high priority.