Vilensky Daniel, Lawrentschuk Nathan, Hersey Karen, Fleshner Neil E
Department of Urology and Surgical Oncology, University Health Network, Princess Margaret Hospital and Toronto General Hospital, Toronto, University of Toronto, ON.
Can Urol Assoc J. 2012 Oct;6(5):E167-73. doi: 10.5489/cuaj.10070. Epub 2011 May 1.
Continued tobacco use following a bladder cancer (CaB) diagnosis puts patients at risk for other tobacco-associated diseases and has also been associated with heightened risks of treatment-related complications, tumour recurrence, morbidity and mortality. Our aim was to determine if patients with CaB who continue to smoke warrant a smoking cessation program as a resource for improving their prognosis and long-term health.
A cross-sectional quantitative questionnaire-based study was performed between January and April 2009. We surveyed patients with a pathologically confirmed diagnosis of CaB during their cystoscopy appointments at a single cancer centre.
One hundred patients completed the survey with 72% of them admitting to smoking in their lifetime. A third of respondents smoked at the time of their diagnosis; 76% of patients who had been active smokers at the time of their diagnosis (n = 33) reported smoking at some point thereafter and 58% continued to smoke. Among continued smokers, they were classified in the following categories: 26% were in "precontemplation," 5% in "contemplation," 16% in "preparation," and 53% in "action;" 37% of patients who continued to smoke were interested in a hospital-based smoking cessation program. Overall, 70% reported smoking as a risk factor for a poor CaB prognosis. The two most common barriers to quitting were "trouble managing stress and mood" and "fear of gaining weight."
Based on the data from our centre, patients with CaB who continue to smoke after their diagnosis warrant a smoking cessation program as a resource for improving prognosis and long-term health. Further research should focus on establishing an efficacious and cost-effective program that provides these patients with the resources they need to quit smoking.
膀胱癌（CaB）确诊后继续吸烟会使患者面临患其他烟草相关疾病的风险，还与治疗相关并发症、肿瘤复发、发病率和死亡率的风险增加有关。我们的目的是确定确诊后继续吸烟的CaB患者是否需要一个戒烟项目，作为改善其预后和长期健康的一种资源。
2009年1月至4月进行了一项基于问卷调查的横断面定量研究。我们在一个单一癌症中心对膀胱镜检查时经病理确诊为CaB的患者进行了调查。
100名患者完成了调查，其中72%的人承认一生中有过吸烟行为。三分之一的受访者在确诊时吸烟；确诊时为现吸烟者的患者中（n = 33），76%报告此后在某些时候仍在吸烟，58%继续吸烟。在继续吸烟者中，他们被分类如下：26%处于“未考虑戒烟”阶段，5%处于“考虑戒烟”阶段，16%处于“准备戒烟”阶段，53%处于“正在戒烟”阶段；37%继续吸烟的患者对医院的戒烟项目感兴趣。总体而言，70%的人报告吸烟是CaB预后不良的一个风险因素。戒烟的两个最常见障碍是“难以应对压力和情绪”以及“担心体重增加”。
根据我们中心的数据，确诊后继续吸烟的CaB患者需要一个戒烟项目，作为改善预后和长期健康的一种资源。进一步的研究应侧重于建立一个有效且具有成本效益的项目，为这些患者提供戒烟所需的资源。
