Institute of Clinical Epidemiology, Key Laboratory of Public Health Safety, Ministry of Education, Key Lab of Health Technology Assessment of Ministry of Health, School of Public Health, Fudan University, Shanghai, China.
Cancer Med. 2019 Mar;8(3):1066-1073. doi: 10.1002/cam4.1999. Epub 2019 Feb 8.
To examine the association between smoking status and quality of life (QOL) among cancer survivors in China.
A cross-sectional study was performed in 2725 male cancer survivors who were members of Cancer Rehabilitation Club and completed the questionnaires in 2013. Using linear regression models adjusted for confounders, we measured the association between QOL and former smokers as well as current (occasional, <10 cigarettes/day, and ≥ 10 cigarettes/day) smokers compared with never smokers.
Current smokers were reported to have higher scores in social, role, cognitive functioning, and had lower scores in nausea/vomiting, pain, dyspnea, and insomnia (P < 0.05). Former smokers had higher global health status and experienced less appetite loss and constipation (P < 0.05). Compared with never smokers, those former smokers and current smokers had significantly high scores on the global health status, social functioning, role functioning, and cognitive functioning (P < 0.05). And they had lower scores in some aspects of symptom scale (P < 0.05). Considering the dose of smoking, the scores were increased in functional subscales and decreased in symptom subscales with the increase of tobacco use, though few variables had statistical significance. As for smoking cessation, the proportion of lung cancer survivors who quit smoking was higher than that of other types of cancer survivors.
Our study suggested the possibility that in China, where smoking prevalence is still high, continued smoking was associated with high QOL scores. The phenomenon may be obscured by some potential reasons, including subjectivity of questionnaire, special substances of cigarettes, Chinese unique culture of tobacco use, and much more. The results reminded researchers and clinicians some underlying situations among smokers in China and prompted a strong call for the implementation of a comprehensive tobacco-control policy and specific public health educational strategies among not only lung cancer survivors but other types of cancers survivors.
探讨中国癌症幸存者吸烟状况与生活质量(QOL)的关系。
2013 年,对 2725 名男性癌症幸存者进行了一项横断面研究,这些幸存者是癌症康复俱乐部的成员并完成了问卷调查。采用调整混杂因素的线性回归模型,我们测量了与从不吸烟者相比,以前吸烟者和当前(偶尔、<10 支/天和≥10 支/天)吸烟者的 QOL 之间的关联。
与从不吸烟者相比,当前吸烟者的社会功能、角色功能、认知功能评分较高,恶心/呕吐、疼痛、呼吸困难和失眠评分较低(P<0.05)。以前吸烟者的总体健康状况较高,且经历的食欲减退和便秘较少(P<0.05)。与从不吸烟者相比,以前吸烟者和当前吸烟者的总体健康状况、社会功能、角色功能和认知功能评分显著较高(P<0.05)。而且他们在某些症状量表方面的评分较低(P<0.05)。考虑到吸烟量,随着烟草使用量的增加,功能子量表的评分增加,症状子量表的评分降低,但少数变量具有统计学意义。至于戒烟,肺癌幸存者戒烟的比例高于其他类型癌症幸存者。
我们的研究表明,在中国,吸烟率仍然很高的情况下,持续吸烟与较高的 QOL 评分有关。这种现象可能被一些潜在的原因所掩盖,包括问卷的主观性、香烟的特殊物质、中国独特的烟草使用文化等等。这些结果提醒研究人员和临床医生注意中国吸烟者的一些潜在情况,并强烈呼吁实施全面的控烟政策和针对不仅是肺癌幸存者,而且是其他类型癌症幸存者的特定公共卫生教育策略。