Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis.

Background: Smoking is detrimental to recovery and survival from cancer, but many cancer survivors continue to smoke. Information is lacking on smoking patterns of survivors many years after diagnosis and correlates of smoking status and patterns, likelihood of quitting, and intentions to quit.

Methods: Cross-sectional analyses were conducted among survivors of 10 cancers recruited by stratified random sampling from cancer registries in a nationwide, longitudinal, quality-of-life study (n = 2,938).

Results: Approximately 9 years after diagnosis, 9.3% of all survivors were current (past 30-day) smokers. Smoking prevalence was highest among survivors of bladder (17.2%), lung (14.9%), and ovarian (11.6%) cancers. Most current smokers (83%) smoked daily, averaging 14.7 cigarettes per day (cpd). Forty percent of daily smokers smoked more than 15 cpd. Nondaily smokers smoked a mean of 10.9 days in the last 30 days and averaged 5.7 cpd on smoking days. Current smoking was associated with younger age, lower education and income, and greater alcohol consumption. Quitting after diagnosis was associated with having a smoking-related cancer. Roughly, a third of current smokers intended to quit, 40% within the next month. The odds of intending to quit were lower if survivors were married, older, or smoked more.

Conclusions: This population-based study indicated that smoking can persist long after initial diagnosis and at high levels and identified characteristics associated with quitting and intentions to quit.

Impact: Findings can be used to identify survivors most at risk for continued smoking and to inform tailoring of cessation treatments for survivors.