257908 Why do cancer patients smoke and what can providers do about it?

Wednesday, October 31, 2012

Sonia Duffy, PhD, RN, FAAN , Ann Arbor VA Center for Clinical Management Research and the University of Michigan, School of Nursing, Ann Arbor VA Medical Center, Ann Arbor, MI
Samantha Louzon, BS , Ann Arbor VA Center for Clinical Management Research, Ann Arbor VA Medical Center, Ann Arbor, MI
Ellen R. Gritz, PhD , Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
Purpose: Despite the wide-spread dissemination of the health risks associated with smoking, many cancer patients continue to smoke resulting in decreased quality of life, increased probability of cancer recurrence, and decreased survival time. To better assist cancer patients to quit smoking, this review will describe the unique issues related to smoking and quitting smoking among cancer patients. Methods: Literature searches were done electronically though MEDLINE and PUBMED. The most recent evidence from scientific literature was considered. Results: Cancer patients are particularly vulnerable to smoking as they have high levels of nicotine dependence, lack of access to cessation services, and high relapse rates. Cancer patients often have a low perceived risk of smoking, a large social network of other smokers, elevated psychological distress, problem drinking, low intake levels of fruits and vegetables, and low levels of physical activity. There are several barriers to providing smoking cessation to cancer patients such as lack of education of providers, hesitancy to upset patients, and scheduling conflicts. System-wide interventions that include brief advice from physicians followed by intensive cessation interventions and state supported telephone quit lines have been shown to enhance quit rates. Conclusion: Efficacious interventions are available to assist cancer patients to quit smoking, yet smoking cessation interventions are often not implemented. Joint actions by clinicians, administrators, insurers, and purchasers can encourage a culture of health care in which tobacco cessation interventions are implemented consistent with evidenced-based standards of care. Implementing efficacious tobacco cessation interventions can reduce morbidity and mortality among cancer patients.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
1. Identify reasons why cancer patients continue to smoke. 2. Identify consequences of continued smoking in cancer patients. 3. Identify smoking cessation interventions for cancer patients.

Keywords: Smoking, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because, having a background in public health and epidemiology, I have worked on multiple federally funded grants focusing on translational interventions to change health behaviors among veterans, particularly related to smoking cessation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.