Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Nicotine Tob Res. 2022 Oct 17;24(10):1581-1588. doi: 10.1093/ntr/ntac072.
Continued cigarette smoking is a critical determinant of outcome in oncology patients, but how the separate events of cancer diagnosis, cancer treatment, and completion of treatment affect smoking behavior in cancer survivors is unknown. This study described such changes, hypothesizing that they would be more pronounced for smoking-related cancers.
The Cancer Patient Tobacco Use Questionnaire (CTUQ) was sent to every cancer patient ≥ 18 y old scheduled for outpatient visits at the Mayo Clinic Cancer Center with a current or former history of tobacco use.
From September 2019 to September 2020, 33,831 patients received the CTUQ, and 20,818 (62%) responded. Of the 3007 current smokers analyzed, 34% quit at diagnosis; those with smoking-related cancers were more likely to quit (40% vs. 29%, respectively, p < .001). Among those who did not quit at diagnosis, 31% quit after starting cancer treatment, and those with smoking-related cancers were more likely to quit (35% and 28%, respectively, p = .002) Among those who had quit before the completion of treatment, 13% resumed smoking after treatment ended. In multivariable analysis, patients with smoking-related cancers were more likely to report 30-d point prevalence abstinence from pre-diagnosis to the completion of treatment (adjusted OR 1.98 [95% CI 1.65, 2.36], p < .001).
Both cancer diagnosis and treatment prompt smoking abstinence, with most maintaining abstinence after treatment is completed. Those with smoking-related cancers are more likely to quit. These results emphasize the need to provide access to tobacco treatment services that can further support cancer patients who smoke.
Approximately one-third of cancer patients who smoke quit smoking at the time of diagnosis, an additional one-third of patients who had not yet quit did so at the initiation of treatment, and most sustained this abstinence after treatment completion. Patients with smoking-related cancers are more likely to quit. Thus, there are multiple opportunities within the cancer care continuum to intervene and support quit attempts or continued abstinence.
持续吸烟是肿瘤患者预后的关键决定因素，但癌症诊断、癌症治疗和治疗完成这三个独立事件如何影响癌症幸存者的吸烟行为尚不清楚。本研究描述了这些变化，并假设这些变化在与吸烟有关的癌症患者中更为明显。
癌症患者烟草使用问卷（CTUQ）发送给梅奥诊所癌症中心每一位≥18 岁的正在接受门诊治疗且有当前或既往吸烟史的癌症患者。
2019 年 9 月至 2020 年 9 月，共有 33831 名患者收到 CTUQ，其中 20818 名（62%）做出了回应。在 3007 名当前吸烟者中，34%在诊断时就已经戒烟；与吸烟有关的癌症患者更有可能戒烟（分别为 40%和 29%，p<0.001）。在那些没有在诊断时戒烟的人中，31%在开始癌症治疗后戒烟，与吸烟有关的癌症患者更有可能戒烟（分别为 35%和 28%，p=0.002）。在治疗结束前已经戒烟的人中，有 13%在治疗结束后重新开始吸烟。在多变量分析中，与吸烟有关的癌症患者更有可能报告从诊断前到治疗完成的 30 天点预存期内的戒烟率（调整后的 OR 1.98 [95%CI 1.65，2.36]，p<0.001）。
癌症诊断和治疗都会促使患者戒烟，大多数患者在治疗结束后继续保持不吸烟。与吸烟有关的癌症患者更有可能戒烟。这些结果强调需要提供获得烟草治疗服务的机会，以进一步支持吸烟的癌症患者。
大约三分之一的吸烟癌症患者在诊断时就已经戒烟，还有三分之一尚未戒烟的患者在开始治疗时就已经戒烟，而且大多数人在治疗结束后仍然保持这种不吸烟状态。与吸烟有关的癌症患者更有可能戒烟。因此，在癌症护理连续体中有多个机会进行干预，支持戒烟尝试或持续戒烟。
