College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
Department of Radiation Oncology, Townsville University Hospital, Townsville, Queensland, Australia.
J Med Imaging Radiat Oncol. 2021 Apr;65(2):233-241. doi: 10.1111/1754-9485.13158. Epub 2021 Feb 23.
This study investigated the smoking behaviours and cessation rates of head and neck cancer (HNC) patients, and their barriers and facilitators to cessation.
The study used a mixed methods, sequential explanatory design. The quantitative data were collected at baseline (around time of cancer diagnosis) via a survey prior to commencement of treatment. Participants identified as current smokers at baseline were then followed up to determine their smoking status after treatment and asked to participate in one-on-one, semi-structured interviews.
Sixty-four participants with HNC were recruited, with 29 classified as current smokers. The 7-day point prevalence cessation rate for current smokers was 72% at 1-month follow-up, and 67% at 3 months, while continuous smoking cessation was 54% at 1 month, and 42% at 3 months. Participants who continued smoking were found to consume more alcohol (P = 0.032), be in a lower stage of change (pre-contemplation or contemplation stages of the transtheoretical model) at baseline (P = 0.012) and be less confident in being able to cease smoking (P = 0.004). Qualitative analysis revealed 5 key themes associated with smoking cessation: the teachable moment of a cancer diagnosis and treatment, willpower and cessation aids, psychosocial environment, relationship with alcohol and marijuana, and health knowledge and beliefs surrounding smoking and cancer.
This study demonstrates that the majority of HNC patients achieve smoking cessation, but relapses are common. Cessation programmes should be developed that are comprehensive, sustained and address factors such as alcohol, marijuana and depression.
本研究调查了头颈部癌症（HNC）患者的吸烟行为和戒烟率，以及他们戒烟的障碍和促进因素。
本研究采用混合方法、顺序解释设计。定量数据是在基线（癌症诊断前后）通过治疗开始前的调查收集的。基线时被确定为当前吸烟者的参与者随后被跟踪，以确定他们在治疗后的吸烟状况，并邀请他们参加一对一的半结构化访谈。
共招募了 64 名头颈部癌症患者，其中 29 名被归类为当前吸烟者。在 1 个月的随访中，当前吸烟者的 7 天点患病率戒烟率为 72%，3 个月时为 67%，而持续戒烟率在 1 个月时为 54%，3 个月时为 42%。研究发现，继续吸烟的参与者饮酒量更高（P=0.032），在基线时处于变化的较低阶段（转变理论模型的前沉思或沉思阶段）（P=0.012），并且对戒烟的信心较低（P=0.004）。定性分析揭示了与戒烟相关的 5 个关键主题：癌症诊断和治疗的可教时刻、意志力和戒烟辅助工具、心理社会环境、与酒精和大麻的关系，以及吸烟和癌症的健康知识和信念。
本研究表明，大多数头颈部癌症患者实现了戒烟，但复发很常见。应制定全面、持续的戒烟计划，解决酒精、大麻和抑郁等因素。
