Smoking Cessation in Patients Diagnosed with Head and Neck Cancer
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OBJECTIVE: To determine patients' smoking status after the diagnosis and treatment of squamous cell carcinoma of the head and neck (SCCHN) and to identify factors associated with smoking cessation. DESIGN: Cross-sectional survey study conducted over a 2-year period. SETTING: Head and neck surgery clinic of an academic tertiary care hospital. METHODS: Two hundred thirteen consecutive patients diagnosed with SCCHN were interviewed to ascertain patients' smoking status and the incidence of smoking cessation. Information on demographics, tobacco and alcohol history, disease characteristics, and treatment modality was also collected. MAIN OUTCOME MEASURES: The rate of smoking cessation was evaluated, in which smoking cessation is defined as the use of no cigarettes at least 1 month prior to the interview. Possible predictors of smoking cessation were evaluated. RESULTS: One hundred twenty-five patients were found to be smoking at the time of diagnosis. Among these patients, 53.6% stopped smoking after diagnosis or during treatment. In the univariate analyses, tumour site (p = .01), concurrent alcohol use (p = .03), and number of attempts to quit pre- (p = .03) and postdiagnosis (p = .001) were found to be highly predictive of patient smoking cessation. Multivariable modelling showed that gender, tumour site, and number of attempts to quit smoking were significantly and independently related to smoking cessation. CONCLUSIONS: Although smoking cessation would be presumed to be high after cancer diagnosis, this study has identified patient subgroups in which postdiagnosis smoking cessation intervention programs need to be made more effective.
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