Even a cancer diagnosis is often not enough to make smokers to quit, according to new research.
Nearly 10 percent of cancer survivors reported smoking years after the diagnosis, according to the American Cancer Society. That number was even higher for those smokers who’d survived bladder and lung cancer, which are strongly associated with smoking.
Studies have shown that about 30 percent of smokers diagnosed with cancer quit, but many don’t in the immediate aftermath. Research of survivors over a longer period has not been done.
The survivors described in the research were not occasional smokers. Eighty-three percent reported smoking nearly 15 cigarettes a day.
Smoking can lessen the effects of cancer treatments, place a patient at greater risk for recurrence and shorten survival time.
For the study, Lee Westmaas, the director of the American Cancer Society’s Tobacco Control Research, Behavioral Research Center and lead author of the paper, examined survey responses of 2,938 patients from the American Cancer Society’s Study of Cancer Survivors nine years after they were diagnosed with cancer.
Several factors increased the likelihood that a cancer survivor would keep smoking. Those who were younger, less educated, with lower incomes and greater alcohol consumption were more likely to smoke, researchers found.
Forty percent of the smokers interviewed said they were planning to quit within a month, but that rate fell if the survivor was married, older or was a heavier smoker, researchers said.
Westmaas said that while healthcare providers want to help cancer survivors quit, “the delivery of cessation advice or asking them if they’re still smoking is not at the levels we want.”
He added that many cancer patients who were still smoking don’t know about free resources that can help them quit. Also, he said, they may not know about effective medications that can increase the odds of kicking the habit.
Among smokers in general, the American Cancer Society estimates that only between four and seven percent are able to successfully stop smoking without medicines or psychological support. Those who used a medication were able to quit successfully for over 6 months at a 25 percent rate. Counseling can further boost those numbers.
Smoking is a “pretty hard habit to break,” said Westmaas.
“I think it points to the addictiveness [of tobacco] that many who were still smoking, were smoking at high rates. Smoking at that level makes it difficult to quit."
Westmaas said that with cancer patients there could be additional hurdles to quitting, including anxiety, depression and physical pain.
“We need to continue to ask survivors about their smoking,” he said. “And make sure they know about and can access treatment.”
The research appeared in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR).