University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada.
J Oncol Pract. 2018 May;14(5):e269-e279. doi: 10.1200/JOP.17.00029. Epub 2018 Apr 20.
Continued smoking after a cancer diagnosis leads to poorer treatment outcomes, survival, and quality of life. We evaluated the perceptions of the effects of continued smoking on quality of life, survival, and fatigue among patients with cancer after a cancer diagnosis and the effects of these perceptions on smoking cessation.
Patients with cancer from all disease subsites from Princess Margaret Cancer Centre (Toronto, Ontario) were surveyed between April 2014 and May 2016 for sociodemographic variables, smoking history, and perceptions of continued smoking on quality of life, survival, and fatigue. Multivariable regression models evaluated the association between patients' perceptions and smoking cessation and the factors influencing patients' perceptions of smoking.
Among 1,121 patients, 277 (23%) were smoking cigarettes up to 1 year before diagnosis, and 54% subsequently quit; 23% had lung cancer, and 27% had head and neck cancers. The majority felt that continued smoking after a cancer diagnosis negatively affected quality of life (83%), survival (86%), and fatigue (82%). Current smokers during the peridiagnosis period were less likely to perceive that continued smoking was harmful when compared with ex-smokers and never-smokers ( P < .01). Among current smokers, perceiving that smoking negatively affected quality of life (adjusted odds ratio [aOR], 2.68 [95% CI, 1.26 to 5.72]; P = .011), survival (aOR, 5.00 [95% CI, 2.19 to 11.43]; P < .001), and fatigue (aOR, 3.57 [95% CI, 1.69 to 7.54]; P < .001) were each strongly associated with smoking cessation. Among all patients, those with a greater smoking history were less likely to believe that smoking was harmful in terms of quality of life (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), survival (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), and fatigue (aOR, 0.99 [95% CI, 0.98 to 0.99]; P < .001).
The perceptions of continued smoking after a cancer diagnosis among patients with cancer are strongly associated with smoking cessation. Counseling about the harms of continued smoking in patients with cancer, and in particular among those who have lower risk perceptions, should be considered when developing a smoking cessation program.
癌症诊断后继续吸烟会导致治疗结果更差、生存率降低和生活质量下降。我们评估了癌症患者在癌症诊断后对继续吸烟对生活质量、生存和疲劳影响的看法，以及这些看法对戒烟的影响。
2014 年 4 月至 2016 年 5 月，我们对来自玛格丽特公主癌症中心（安大略省多伦多）所有疾病部位的癌症患者进行了调查，调查内容包括社会人口统计学变量、吸烟史以及对继续吸烟对生活质量、生存和疲劳的影响的看法。多变量回归模型评估了患者看法与戒烟之间的关联，以及影响患者对吸烟看法的因素。
在 1121 名患者中，277 名（23%）在诊断前 1 年内吸烟，其中 54%随后戒烟；23%患有肺癌，27%患有头颈部癌症。大多数患者认为癌症诊断后继续吸烟会对生活质量（83%）、生存（86%）和疲劳（82%）产生负面影响。与以前吸烟的人和从不吸烟的人相比，在诊断期间吸烟的当前吸烟者不太可能认为继续吸烟有害（P<0.01）。在当前吸烟者中，认为吸烟对生活质量有负面影响（调整后的优势比 [aOR]，2.68 [95%CI，1.26 至 5.72]；P=0.011）、生存（aOR，5.00 [95%CI，2.19 至 11.43]；P<0.001）和疲劳（aOR，3.57 [95%CI，1.69 至 7.54]；P<0.001）都与戒烟密切相关。在所有患者中，吸烟史较长的患者不太可能认为吸烟对生活质量（aOR，0.98 [95%CI，0.98 至 0.99]；P<0.001）、生存（aOR，0.98 [95%CI，0.98 至 0.99]；P<0.001）和疲劳（aOR，0.99 [95%CI，0.98 至 0.99]；P<0.001）有危害。
癌症患者对癌症诊断后继续吸烟的看法与戒烟密切相关。在制定戒烟计划时，应考虑针对癌症患者，特别是那些风险认知较低的患者，进行有关继续吸烟危害的咨询。
