More than a quarter of cancer survivors who still smoke have not been advised to quit smoking by their health care providers in the last year, according to a study published by researchers at Fox Chase Cancer Center in the current issue of the Journal of General Internal Medicine. The findings suggest that health care providers - from doctors to dentists to nurses - are missing an opportunity to make a dramatic difference in the quality of life of their patients.
"While smoking cessation is difficult, it can play an important role in increasing cancer survivors' quality of life," says the paper's lead author Elliot Coups, Ph.D., former associate member of Fox Chase Cancer Center's faculty and a participant in the Fox Chase Keystone Program in Cancer Risk and Prevention. "Time and again, studies have shown that people really do listen to what is said at the doctor's office in regards to smoking, so health care providers need to take advantage of this teachable moment."
According to Coups, an associate professor of medicine at UMDNJ-Robert Wood Johnson Medical School, who recently joined the Division of Public Health Science at The Cancer Institute of New Jersey, the harmful effects of smoking have an important impact on cancer survivors. Smoking is known to adversely affect survivors' quality of life, lower their projected life-spans, and to increase their risk for cardiovascular disease, as well as second, unrelated cancers.
"With improvements in cancer medicine, we are seeing a growing population of cancer survivors who are returning to their primary physicians with their unique medical issues," says Carolyn Heckman, Ph.D., assistant professor at Fox Chase Cancer Center and a co-author of the study. "Smoking cessation, in particular, needs to be addressed at every visit with a health care provider."
Coups and his colleagues drew the data for this study from 1,825 participants in the 2005 National Health Interview Survey conducted by the National Center for Health Statistics. The participants were survivors of an array of cancers, including cervical, colon, breast, melanoma, uterine and prostate cancer.
Nearly all of those surveyed reported visiting a health care provider within the previous year. Among the 18 percent of cancer survivors who reported currently smoking, nearly 65 percent indicated they wanted to quit smoking and 40 percent had tried to quit within the last year. The study found that when survivors try to quit smoking they, unfortunately, tend not to use evidence-based behavioral treatments or pharmacotherapies (such as nicotine patches or gum), which is consistent with the general population of smokers.
"This survey cannot tell us why these people did not get the help quitting that they needed or why some survivors didn't receive smoking cessation advice from their health care providers," Coups says. "Yet it should serve as encouragement to health care providers to talk about smoking with their cancer survivor patients, and not to assume that another provider is taking care of the problem. Survivors especially need guidance in using evidence-based smoking cessation treatments."
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