Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.
Ontario Cancer Institute, Toronto, Ontario, Canada.
Cancer. 2015 Aug 1;121(15):2655-63. doi: 10.1002/cncr.29340. Epub 2015 Apr 15.
Second-hand smoke (SHS) is a significant barrier to smoking cessation after a diagnosis of cancer in patients with lung as well as head and neck cancers. In the current study, the authors evaluated the effect of SHS on smoking cessation among patients with those cancers not traditionally perceived to be strongly associated with smoking.
Patients recruited from a single tertiary care center completed a self-administered questionnaire. Multivariate logistic regression and Cox proportional hazards models evaluated the association of sociodemographics, clinicopathological variables, and exposure to SHS with either smoking cessation or time to quitting.
In all, 926 patients with diverse cancer subtypes completed the questionnaire. Of the 161 who were current smokers at the time of their cancer diagnosis, 48% quit after diagnosis. Lack of exposure to SHS at home was found to be associated with smoking cessation at any time after diagnosis (adjusted odd ratio, 4.28; 95% confidence interval, 1.56-11.78 [P =.005]), with similar trends noted 1 year after diagnosis (adjusted odds ratio, 2.56; 95% confidence interval, 0.91-7.22 [P =.08]). There was a significant inverse dose-response relationship between hours of SHS exposure at home and smoking cessation. Spousal and peer smoking were not found to be significantly associated with smoking cessation on multivariate analysis (P>.05). Kaplan-Meier analysis found that of patients who did quit smoking, 61% quit within 6 months of their cancer diagnosis.
Exposure to SHS at home is a significant barrier to smoking cessation in patients whose cancers are not traditionally perceived as being related to tobacco. SHS should be a key consideration in the development of survivorship programs geared toward smoking cessation for all patients with cancer.
二手烟（SHS）是肺癌以及头颈部癌症患者确诊癌症后戒烟的一个重大障碍。在本研究中，作者评估了 SHS 对那些传统上与吸烟关联性不强的癌症患者戒烟的影响。
从一家三级护理中心招募的患者完成了一份自我管理问卷。多变量逻辑回归和 Cox 比例风险模型评估了社会人口统计学、临床病理变量以及暴露于 SHS 与戒烟或戒烟时间之间的关联。
共有 926 名患有不同癌症亚型的患者完成了问卷。在确诊癌症时为当前吸烟者的 161 人中，有 48%在诊断后戒烟。在家中未接触 SHS 与诊断后任何时间的戒烟有关（调整后的优势比，4.28；95%置信区间，1.56-11.78[P=.005]），在诊断后 1 年也有类似的趋势（调整后的优势比，2.56；95%置信区间，0.91-7.22[P=.08]）。在家中接触 SHS 的时间与戒烟呈显著负相关。多变量分析发现，配偶和同伴吸烟与戒烟无显著相关性（P＞.05）。Kaplan-Meier 分析发现，确实戒烟的患者中，有 61%在癌症诊断后 6 个月内戒烟。
在家中接触 SHS 是那些传统上与吸烟关联性不强的癌症患者戒烟的一个重大障碍。在制定针对所有癌症患者的戒烟生存计划时，应将 SHS 作为一个关键因素考虑在内。
