Health & Medicine - Posted by Laura Bailey-Michigan on Friday, November 30, 2012 17:42 - 3 Comments 
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(1 votes, average: 5.00 out of 5) Loading ...Why patients with cancer don’t quit smoking
"Ours is the first comprehensive review study to examine reasons why the very cause of the cancer, namely smoking, in many cases isn't treated," says Sonia Duffy, who says she wasn't prepared to find so many hurdles hindering smoking cessation in cancer patients. (Credit: Veer)
U. MICHIGAN (US) — Over half of cancer patients don’t quit smoking after their diagnosis, according to a new review paper that identifies the reasons why.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
It’s a sad but familiar scene near the grounds of many medical campuses: hospital-gowned patients, some toting rolling IV poles, huddled in clumps under bus shelters or warming areas, smoking cigarettes.
Smoking causes 30 percent of all cancer deaths and 87 percent of all lung cancer deaths. Yet, roughly 50 percent to 83 percent of cancer patients keep smoking after a cancer diagnosis, through treatment and beyond, says Sonia Duffy, a researcher at the University of Michigan School of Nursing.
For patients who quit on their own, relapse rates (as in the general population) are as high as 85 percent.
Yet, continued smoking severely hampers cancer treatment, increases cancer recurrence, and decreases survival, she says.
While it’s easy to dismiss smoking as a lack of discipline or a disregard for one’s own health, it’s a much more complicated picture for these patients, says Duffy, lead researcher on a review paper which appears in the journal Community Oncology.
“Ours is the first comprehensive review study to examine reasons why the very cause of the cancer, namely smoking, in many cases isn’t treated,” says Duffy, who says she wasn’t prepared to find so many hurdles hindering smoking cessation in cancer patients.
“I think what surprised me when I did the review was the multitude of issues that cancer patients face, and that there are so many variables affecting why they don’t get treatment, and if they do get treatment, why they may not respond. Nicotine addiction, health issues, emotional issues, psychological issues, and system level issues are all in the way.”
Many obstacles
Other obstacles include limited access to quit-smoking programs, little social support, sleep deprivation, poor nutrition, lack of confidence in being able to quit, and socioeconomic status. After back-to-back appointments and grueling chemotherapy or radiation protocols, many cancer patients simply lack time or energy to attend quit-smoking programs, Duffy says.
Depression is another big barrier to quitting smoking, and among cancer patients it’s as high as 58 percent, compared to 10 percent in the general population, she says.
And, while most lung cancer patients understand the relationship between smoking and their diagnosis, head-and-neck-cancer patients often don’t make the connection.
Surprisingly, Duffy’s research suggests that only 56 percent of family physicians urge their cancer patients to quit smoking. Most oncology providers suggest quitting, but the oncologist’s main focus is on cancer treatment.
Duffy’s paper suggests that nurse-administered stop-smoking interventions may be the best way to reach cancer patients who smoke, yet many nurses are not trained to conduct cessation interventions. Her next project will examine ways to specifically design quit-smoking programs for nurses to administer to cancer patients.
Other authors include Samantha Louzon of the Ann Arbor VA Center for Clinical Management Research and Ellen Gritz of the University of Texas MD Anderson Cancer Center.
Source: University of Michigan
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3 Comments
Richard Posner
As someone who has assisted other people in their stop smoking efforts, I suspect that there are a number of factors that come into play as to why cancer patients continue to smoke and these have to be considered when designing interventions. Certainly there are some who have a fatalistic attitude and figure if the damage is done, why stop now? Others may not have a sense of “ownership” when it comes to health and are not accustomed to taking a proactive role. But perhaps the largest obstacle can be the belief that managing an already sky high stress level will be impossible without smoking. Yet I do believe that if a comprehensive package of resources that included coaching, mind/body healing practices like hypnosis and nicotine replacement were made available to these folks, many of them could successfully quit. HOPE IS REALISTIC!
Richard Posner
You’re right, Mr. Malone. Sadly, our government leaders, the men and women we have elected to make our social decisions for us, do not want to ‘spend the money’ on such intensive therapies. You didn’t mention the context for your therapeutic practice, but such multi-focal approaches, while quite successful in all addiction therapies, are not as cheap as pushing pills and fakery, which are far more profitable and don’t require the vast numbers of therapy professionals who much be paid salaries or fees.
Until we, as a society, quit letting ourselves be pushed and pulled by television advertising and unremitting propaganda and jingoism, cancer patients will -need- to smoke to deal with their stress, which they’ve been doing for decades. They won’t get access to the kind of people like you, who might actually help them. “It’s too expensive”. We could, as a society, certainly afford such humanistic programs…if we chose to do so.
Thank you for your work and for helping people who need help.
In the state of Oregon all health care facilities now ban smoking on the entire campus. You can’t smoke in the parking lot, technically, and with cameras everywhere these days, I would imagine to-obvious puffing would get you a visit from security.
As for smoking in general, it’s an addiction. Since the USA penalizes and criminalizes negative behaviors instead of treating them appropriately, this is just another Prohibition. You’d think we’d learn something, but we don’t.