Smoking status among cancer patients by specialty: A U.S. nationwide representative analysis

Cancer Med. 2023 Dec;12(23):21389-21399. doi: 10.1002/cam4.6684. Epub 2023 Nov 20.

Abstract

Background: Persistence in tobacco use among cancer survivors has been associated with a multitude of clinicodemographic factors. However, there is a paucity of understanding regarding the role the healthcare professional's specialty plays in tobacco cessation in tobacco-related cancer survivors.

Methods: We conducted a cross-sectional analysis of data from cancer survivors with a smoking history using the Behavioral Risk Factor Surveillance System (BRFSS) database to examine differences in the proportion of patients continuing tobacco use among patients with a diagnosis of cancer segregated by cancer site specialty over the 2016-2020 period. We accounted for complex survey design and used sampling weights to obtain a nationwide representative sample. We employed modified Poisson regression adjusting for age, gender, education, income, race, marital status, and medical specialty.

Results: We analyzed 19,855 cancer survivors with a current or past history of tobacco use, of whom 5222 (26,3%) self-reported to be current smokers. Patients with urological and gynecological tobacco-related malignancies had a higher relative risk (RR) of being current smokers with a RR of 1.30 (95% confidence interval, 1.12-1.51) and 1.25 (95% confidence interval, 1.12-1.39) respectively. Malignant Hematology had the lowest RR of smoking status among all other specialties RR 0.85 (95% confidence interval, 0.59-1.21).

Conclusions: Continuing smoking rates among tobacco-related cancer survivors were different between specialties. One in four cancer survivors were current smokers; this emphasizes health professionals' paramount role in tobacco cessation counseling.

Keywords: cancer survivors; physicians; smoking cessation; tobacco.

MeSH terms

  • Cancer Survivors*
  • Cross-Sectional Studies
  • Humans
  • Neoplasms* / epidemiology
  • Neoplasms* / etiology
  • Neoplasms* / psychology
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / psychology
  • Smoking Cessation*