Hoag Urologic Oncology, Hoag Health Network, Orange County, CA.
Departments of Urology and Population Health, New York University, New York, NY.
Urology. 2021 Jul;153:236-243. doi: 10.1016/j.urology.2020.12.033. Epub 2021 Jan 13.
To assess the prevalence and correlates of successful smoking cessation in bladder cancer survivors.
A population-based sample of bladder cancer survivors diagnosed over a 3 year period was obtained from the California Cancer Registry. Respondents completed a survey about their tobacco use and attempts at smoking cessation. Contingency tables and logistic regression analyses were used to evaluate for correlates of successful smoking cessation.
Of total survey respondents, 19% (151 of 790) were active smokers at bladder cancer diagnosis and made up our analytic cohort. The majority of included respondents were male, older than 60, and had smoked for >40 years prior to diagnosis. After diagnosis, 76% (115 of 151) of active smokers made a quit attempt and 56% (65 of 115) were successful. Success with smoking cessation was more frequent among those who attempted to quit around the time of initial bladder cancer diagnosis. The majority (66%) of successful quitters did so "cold turkey" without pharmacotherapy or behavioral therapy. After adjustment for demographic and tobacco-related factors, quit attempts specifically motivated by the bladder cancer diagnosis were highly associated with smoking cessation success (OR 11.6; 95% CI 3.73-35.8). Use of pharmacologic or behavioral therapies in the quit attempt were not significantly associated with successful smoking cessation.
Our data underscore the importance of motivation, timing, and the role of the urologist in the quit attempts of bladder cancer survivors. Emphasis should be placed on ensuring the newly diagnosed make a timely quit attempt informed by the causal role of smoking in their malignancy.
评估膀胱癌幸存者成功戒烟的流行率和相关因素。
从加利福尼亚癌症登记处获得了一个基于人群的膀胱癌幸存者样本，这些患者在过去 3 年中被诊断出患有膀胱癌。受访者完成了一份关于他们吸烟和戒烟尝试的调查。使用列联表和逻辑回归分析来评估成功戒烟的相关因素。
在总调查受访者中，19%（790 名中的 151 名）在膀胱癌诊断时为活跃吸烟者，构成了我们的分析队列。大多数纳入的受访者为男性，年龄大于 60 岁，在诊断前吸烟超过 40 年。在诊断后，76%（151 名中的 115 名）的活跃吸烟者尝试戒烟，其中 56%（115 名中的 65 名）成功。在膀胱癌诊断时开始戒烟尝试的患者中，戒烟成功的比例更高。大多数（66%）成功戒烟者没有使用药物治疗或行为疗法就“突然”戒烟。在调整了人口统计学和与吸烟相关的因素后，专门由于膀胱癌诊断而尝试戒烟与戒烟成功高度相关（OR 11.6；95%CI 3.73-35.8）。戒烟尝试中使用药物或行为疗法与成功戒烟无显著相关性。
我们的数据强调了动机、时机以及泌尿科医生在膀胱癌幸存者戒烟尝试中的作用的重要性。应该强调的是，要确保新诊断的患者及时戒烟，同时了解吸烟在其癌症中的因果作用。
