Martinez Ursula, Brandon Thomas H, Cottrell-Daniels Cherell, McBride Colleen M, Warren Graham W, Meade Cathy D, Palmer Amanda M, Simmons Vani N
Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.
Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
J Cancer Educ. 2025 Apr;40(2):192-201. doi: 10.1007/s13187-024-02493-y. Epub 2024 Sep 6.
Smoking by cancer patients impairs treatment outcomes and prognoses across cancer types. Previous research shows greater smoking cessation motivation and quit rates among patients with cancers strongly linked to smoking (i.e., thoracic, head and neck) compared to other cancer types (e.g., melanoma). Therefore, there is a need to increase cessation motivation among patients with malignancies less commonly associated with smoking. Yet, no targeted educational materials exist to meet this information gap. This manuscript describes the development of theory-based self-help educational materials, targeted by cancer type, to increase motivation to quit smoking among patients with cancers not widely perceived as smoking-related (i.e., breast, melanoma, bladder, colorectal, gynecological). Using a three-phase iterative process, we first conducted in-depth interviews with our intended audience (N = 18) to identify information needs and nuanced content. Themes included patients' low knowledge about the connection between smoking and cancer etiology and outcomes; negative affect, habit, dependence, and weight gain as quitting barriers; and a preference for positive and non-judgmental content. Second, content creation was based on interview findings, the scientific literature, and framed following the teachable moment model. Last, learner verification and revisions via interviews with 22 patients assessed suitability of draft materials, with generally favorable responses. Resulting edits included tailoring cost savings to the cancer context, explaining cessation medications, and increasing appeal by improving the diversity (e.g., race) of the individuals in the photographs. The final booklets are low cost, easy to disseminate, and-pending efficacy studies-may expand smoking cessation to a wider spectrum of cancer patients.
癌症患者吸烟会损害各类癌症的治疗效果和预后。先前的研究表明，与其他癌症类型（如黑色素瘤）相比，与吸烟密切相关的癌症（即胸癌、头颈癌）患者的戒烟动机更强，戒烟率更高。因此，有必要提高与吸烟关联较少的恶性肿瘤患者的戒烟动机。然而，目前尚无针对性的教育材料来填补这一信息空白。本手稿描述了基于理论的自助教育材料的开发过程，这些材料按癌症类型进行了针对性设计，旨在提高被普遍认为与吸烟无关的癌症（即乳腺癌、黑色素瘤、膀胱癌、结直肠癌、妇科癌症）患者的戒烟动机。我们采用三阶段迭代过程，首先对目标受众（N = 18）进行了深入访谈，以确定信息需求和细微内容。主题包括患者对吸烟与癌症病因及预后之间联系的了解不足；消极情绪、习惯、依赖和体重增加是戒烟的障碍；以及对积极且无评判性内容的偏好。其次，内容创作基于访谈结果、科学文献，并按照可教时刻模型进行构建。最后，通过对22名患者的访谈进行学习者验证和修订，评估材料草稿的适用性，总体反馈良好。最终的编辑内容包括根据癌症背景调整成本节约内容、解释戒烟药物，并通过提高照片中人物的多样性（如种族）来增加吸引力。最终的手册成本低、易于传播，并且在进行疗效研究之前，可能会将戒烟推广到更广泛的癌症患者群体。
