Department of Psychiatry, University of Pennsylvania, Philadelphia, 19143, USA.
Acta Oncol. 2011 Jun;50(5):678-84. doi: 10.3109/0284186X.2011.572915. Epub 2011 May 2.
Many cancer patients continue to smoke postdiagnosis, which is associated with poorer clinical outcomes. Identifying prospective predictors of smoking cessation among patients currently receiving smoking cessation treatment can help guide the development and implementation of smoking cessation programs with this population.
Data from 246 cancer patients participating in a randomized placebo-controlled smoking cessation clinical trial were used to examine baseline predictors of end-of-treatment and six-month postbaseline smoking cessation outcomes. Baseline demographic, smoking-related, disease-related, and psychological variables were examined as predictors of biochemically-confirmed point-prevalence abstinence.
Multivariate analysis indicated that, for end-of-treatment abstinence, patients were significantly more likely to have quit smoking if they were older (OR = 1.06, 95% CI: 1.03-1.10, p < 0.05) and were diagnosed with a non-tobacco related cancer (OR = 2.54, 95% CI: 1.24-5.20, p < 0.05). Likewise, for six-month abstinence, patients were significantly more likely to have quit smoking if they were older (OR = 1.04, 95% CI: 1.01-1.08, p < 0.05) and were significantly less likely to have quit smoking if they were female (OR = 0.47, 95% CI: 0.22-0.97, p < 0.05). Patients with tobacco-related cancers and female patients reported significantly higher levels of depression symptoms (p < 0.05), which proved predictive of smoking relapse.
Patient age, gender, and cancer-type may be important factors to consider when developing and implementing smoking cessation interventions for cancer patients.
目的:许多癌症患者在确诊后仍继续吸烟,这与较差的临床结局有关。识别当前接受戒烟治疗的患者戒烟的潜在预测因素,可以帮助指导针对这一人群制定和实施戒烟计划。
材料与方法:本研究使用了 246 名参与随机安慰剂对照戒烟临床试验的癌症患者的数据,以检验治疗结束时和基线后 6 个月的戒烟结局的预测因素。将基线人口统计学、与吸烟相关的、与疾病相关的和心理变量作为生物化学确证的点患病率戒断的预测因素进行检查。
结果:多变量分析表明,对于治疗结束时的戒烟,患者年龄越大(OR = 1.06,95%CI:1.03-1.10,p < 0.05)和诊断为非烟草相关癌症(OR = 2.54,95%CI:1.24-5.20,p < 0.05),更有可能戒烟。同样,对于 6 个月的戒烟,患者年龄越大(OR = 1.04,95%CI:1.01-1.08,p < 0.05),更有可能戒烟,而女性患者(OR = 0.47,95%CI:0.22-0.97,p < 0.05)更不可能戒烟。患有烟草相关癌症和女性患者报告的抑郁症状明显更高(p < 0.05),这证明与吸烟复发有关。
结论:患者年龄、性别和癌症类型可能是制定和实施癌症患者戒烟干预措施时需要考虑的重要因素。