Smoking cessation at bladder cancer diagnosis: Many patients might benefit from this teachable moment

Introduction

Bladder cancer (BCa) is the second most common tobacco-related malignancy.  Greater than 50% of BCa diagnoses in the United States are due to smoking.  For those still smoking at diagnosis, a teachable moment exists for providers to encourage smoking cessation.  Therefore, we sought to determine the impact of the BCa diagnosis on subsequent tobacco use.

Methods

A random sample of persons diagnosed with BCa between 2006 and 2010 was obtained from the California Cancer Registry.  Patients were surveyed regarding tobacco use, cessation attempts, and reasons for cessation using standard prompts from the California Tobacco Survey.  Active smokers with BCa were matched 2:1 to controls in the general population without BCa by gender, age, race, partnership status, and level of education.  Independent sample t tests and χ² tests were used to compare cases and controls.

Results

Of the 775 respondents to our survey, 143 (18%) reported smoking at BCa diagnosis.  Cases were more likely than controls to make a quit attempt (74% vs. 47%, p < .001) and more likely to successfully quit smoking (40% vs. 9%, p < .001).  Reasons for cessation were the diagnosis of BCa (67%), the advice of the urologist (33%), and the advice of the primary care physician (27%).

Conclusions

Active smokers diagnosed with BCa were more likely to make a quit attempt and to successfully quit smoking than matched controls.  More research on ways to optimize the impact of providers’ advice to quit at BCa diagnosis is warranted.