Study finds continued smoking after cancer diagnosis among patients, family caregivers

Nicotine is so addictive for many people that even a cancer diagnosis doesn't help them - or their family members and caregivers - throw the cigarettes away.

Kathryn E. Weaver, Ph.D., M.P.H., an assistant professor in the Department of Social Sciences and Health Policy at Wake Forest Baptist Medical Center, set out to characterize patterns and context of smoking among recently diagnosed cancer patients and their family caregivers.

Weaver and fellow researchers built on prior research by utilizing a large sample of 742 cancer patients and caregivers recruited from multiple sites across the country that included patients with a cancer strongly associated with smoking - lung cancer - and one that is not strongly associated with smoking - colorectal cancer.

"We found that a substantial number of cancer patients continue to smoke after their cancer diagnosis," said Weaver, the lead author of the research that appears this month in the journal "Cancer Epidemiology, Biomarkers & Prevention."

Her team found that 18 percent of lung cancer patients continue to smoke after their diagnosis, while 12 percent of colorectal cancer patients continue smoking.

Weaver said it is concerning, but not necessarily surprising, that such a high number of cancer patients continue to smoke after a diagnosis. "Smoking is a very addictive behavior and it can be difficult to quit smoking. Many of our cancer patients do want to quit smoking and have tried many times in the past, but have been unsuccessful."

Another interesting aspect of the study, said Weaver, is that among cancer patients' family members, who provide a lot of informal care and support for that patient, an even higher proportion of family caregivers were smoking -- 25 percent for lung cancer and 20 percent for colorectal cancer.

Weaver explained that many family members might see the challenges their loved one is experiencing because of cancer and think they really need to quit smoking. However, the disease creates a very stressful period of time for everyone involved and the added stress may make it a difficult time to quit.

"What's important about this study is that a cancer diagnosis may be a teachable moment about smoking cessation for both patients and their family members," Weaver said. "Physicians need to be aware that a substantial number of their patients do continue to smoke after receiving a cancer diagnosis, but they should be offered every encouragement and resource to quit."

Weaver said other research links continued smoking after a cancer diagnosis to the development of new, secondary cancers, treatment complications and decreased effectiveness, reduced overall survival, and poorer quality of life. Oncology physicians should assess all of their patients for current tobacco use and provide tobacco cessation resources for those who are smokers and their family members who smoke.

"We want to make sure that cancer patients understand that it is never too late to experience the health benefits of quitting smoking," she said.