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吸烟与胃肠道癌患者——戒烟是否可行?

Smoking and gastrointestinal cancer patients-is smoking cessation an attainable goal?

机构信息

Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Department of Medicine Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

出版信息

J Surg Oncol. 2019 Dec;120(8):1335-1340. doi: 10.1002/jso.25749. Epub 2019 Oct 31.

Abstract

BACKGROUND AND OBJECTIVES

Negative consequences of tobacco use during cancer treatment are well-documented but more in-depth, patient-level data are needed to understand patient beliefs about continued smoking (vs cessation) during gastrointestinal (GI) cancer treatment.

METHODS

We conducted semi-structured interviews with 10 patients who were active smokers being treated for GI cancers and 5 caregivers of such patients. All interviews were audio-recorded, transcribed verbatim, and uploaded to NVivo. We consensus coded data inductively using conventional content analysis and iteratively developed our codebook. We developed data matrices to categorize the themes regarding patient perspectives on smoking as well as presumed barriers to smoking cessation during active therapy.

RESULTS

Our interviews revealed three consistent themes: (a) Smoking cessation is not necessarily desired by many patients who have received a cancer diagnosis; (b) Failure in past quit attempts may lead to feelings of hopeless about future attempts, especially during cancer treatment; (c) Patients perceived little to no access to smoking cessation treatment at the time of their cancer diagnosis.

CONCLUSIONS

Well-designed systemic changes that promote the positive and efficacious effects of quitting smoking during cancer treatment, and that provide barrier-free access to such treatments may be helpful in promoting tobacco-free behavior during cancer treatment.

摘要

背景与目的

癌症治疗期间吸烟的负面影响已有充分记录,但仍需要更深入的、基于患者层面的数据,以了解患者在胃肠道(GI)癌症治疗期间继续吸烟(而非戒烟)的相关信念。

方法

我们对 10 名正在接受胃肠道癌症治疗的主动吸烟者患者和 5 名此类患者的护理人员进行了半结构化访谈。所有访谈均进行了录音,并逐字转录,然后上传到 NVivo。我们采用传统的内容分析法对数据进行了归纳式共识编码,并对我们的代码本进行了迭代开发。我们开发了数据矩阵,以对患者对吸烟的看法以及在积极治疗期间戒烟的潜在障碍等主题进行分类。

结果

我们的访谈揭示了三个一致的主题:(a)许多被诊断出癌症的患者并不一定希望戒烟;(b)过去戒烟尝试的失败可能导致对未来尝试的绝望感,尤其是在癌症治疗期间;(c)患者在癌症诊断时几乎无法获得戒烟治疗。

结论

精心设计的系统改变,可以促进癌症治疗期间戒烟的积极和有效的影响,并为这些治疗提供无障碍途径,这可能有助于在癌症治疗期间促进无烟行为。

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Depression, smoking and smoking cessation: a qualitative study.抑郁、吸烟与戒烟:一项定性研究。
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本文引用的文献

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Print-based self-help interventions for smoking cessation.基于印刷品的戒烟自助干预措施。
Cochrane Database Syst Rev. 2019 Jan 9;1(1):CD001118. doi: 10.1002/14651858.CD001118.pub4.
2
Do smoking and alcohol behaviours influence GI cancer survival?吸烟和饮酒行为是否会影响胃肠道癌症的生存?
Best Pract Res Clin Gastroenterol. 2017 Oct;31(5):569-577. doi: 10.1016/j.bpg.2017.09.015. Epub 2017 Sep 23.
8
Effects of tobacco smoking and nicotine on cancer treatment.吸烟和尼古丁对癌症治疗的影响。
Pharmacotherapy. 2012 Oct;32(10):920-31. doi: 10.1002/j.1875-9114.2012.01117.
9
Adverse effects of smoking on postoperative outcomes in cancer patients.吸烟对癌症患者术后结局的不良影响。
Ann Surg Oncol. 2012 May;19(5):1430-8. doi: 10.1245/s10434-011-2128-y. Epub 2011 Nov 8.

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