Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health, 4770 Buford Highway, MS F76, Atlanta, GA, 30341, Georgia.
Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, USA.
J Community Health. 2019 Jun;44(3):552-560. doi: 10.1007/s10900-019-00622-z.
To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors.
Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007-2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. TACs included colorectal, pancreatic, and lung cancers; nTAC included breast, ovarian, and prostate cancers.
There were 10,033 TAC and 13,670 nTAC survivors. Smoking before diagnosis was significantly higher among TAC survivors (p < 0.0001). Among TAC survivors, smoking before diagnosis was significantly higher among persons who: were males (83%), aged 45-64 (83%), of unknown marital status (84%), had very low education (78%), had public insurance (89%), Medicaid (85%) or were uninsured (84%). Smoking cessation counseling and pharmacotherapy were more common among TAC than nTAC survivors (p < 0.01 and p = 0.05, respectively).
While smoking cessation counseling and pharmacotherapy were higher among TAC survivors, reducing smoking among all cancer survivors remains a priority, given cancer survivors are at increased risk for subsequent chronic diseases, including cancer. Tobacco cessation among all cancer survivors (not just those with TAC) can help improve prognosis, quality of life and reduce the risk of further disease. Health care providers can recommend for individual, group and telephone counseling and/or pharmacotherapy recommendations. These could also be included in survivorship care plans.
研究与烟草相关癌症（TAC）或非烟草相关癌症（nTAC）幸存者的吸烟和使用戒烟辅助工具的情况。了解何时以及是否使用特定类型的戒烟资源有助于计划干预措施，以更有效地减少所有癌症幸存者的吸烟，但目前对癌症幸存者使用的戒烟方法研究较少。
将肯塔基州癌症登记处 2007-2011 年诊断的肺癌、结直肠癌、胰腺癌、乳腺癌、卵巢癌和前列腺癌的发病数据与健康管理索赔数据（医疗补助、医疗保险、私人保险公司）进行链接，以调查癌症诊断前 1 年和诊断后 1 年的吸烟情况和使用戒烟辅助工具的情况。TAC 包括结直肠癌、胰腺癌和肺癌；nTAC 包括乳腺癌、卵巢癌和前列腺癌。
共有 10033 例 TAC 和 13670 例 nTAC 幸存者。与 nTAC 幸存者相比，TAC 幸存者在诊断前吸烟的比例明显更高（p<0.0001）。在 TAC 幸存者中，诊断前吸烟的比例在以下人群中显著更高：男性（83%）、45-64 岁（83%）、婚姻状况未知（84%）、受教育程度低（78%）、拥有公共保险（89%）、医疗补助（85%）或没有保险（84%）。TAC 幸存者比 nTAC 幸存者更常接受戒烟咨询和药物治疗（p<0.01 和 p=0.05）。
虽然 TAC 幸存者接受戒烟咨询和药物治疗的比例更高，但鉴于癌症幸存者罹患后续慢性疾病（包括癌症）的风险增加，所有癌症幸存者减少吸烟仍然是当务之急。所有癌症幸存者（不仅仅是 TAC 幸存者）的烟草戒断有助于改善预后、生活质量并降低进一步患病的风险。医疗保健提供者可以为个人、团体和电话咨询以及/或药物治疗建议提供建议。这些建议也可以包含在生存者护理计划中。
