FRIDAY, April 8 (HealthDay News) -- Many patients diagnosed with
lung cancer -- as well as their family caregivers -- continue to
smoke even though doing so may jeopardize their recovery and
long-term health outcome, says a study sponsored by the U.S.
National Cancer Institute.
Researchers report that nearly one in five recently diagnosed
lung cancer patients continues to light up, which can make them
feel guilty or socially stigmatized.
"The biggest obstacle is fatalism, the belief that it is too late to quit smoking so why bother," said Kathryn E. Weaver, study lead author and assistant professor of social sciences and health policy at Wake Forest Baptist Medical Center in Winston-Salem, N.C.
"There are benefits to be gained by quitting that have important implications for survival, response to treatments, and quality of life," she said.
The findings point to the need for family support, counseling
and medication to help patients and/or family caregivers overcome
their addiction and adopt healthy lifestyle choices, said
The study was recently published in
Cancer Epidemiology, Biomarkers & Prevention.
The researchers looked at 742 cancer patients and caregivers at
multiple sites and found that 18 percent of smokers with lung
cancer failed to quit after their diagnosis. Smoking is the leading
cause of lung cancer.
Among a subset of smokers with colorectal cancer, which is not
strongly associated with tobacco use, 12 percent of the patients
An even higher proportion of the patients' family caregivers
also kept on smoking -- 25 percent of those caring for lung cancer
patients and 20 percent of those caring for colorectal cancer
patients, the researchers found.
Most of the caregivers were middle-aged females and were often
spouses of the patients. In some cases, both the patient and the
caregiver continued smoking.
If family caregivers see the cancer patient quit, they're more
likely to quit themselves, Weaver said. But if either the patient
or caregiver continues to smoke, it can trigger issues of guilt,
stigma or blame, she added.
Continued smoking increases the likelihood of developing a
secondary cancer and can interfere with treatment, the researchers
Another clinical reason to stop smoking, said Dr. Norman H.
Edelman, chief medical officer of the American Lung Association, is
that chronic obstructive pulmonary disorder (COPD) usually
accompanies lung cancer, making it more difficult to breathe.
Continued smoking exacerbates COPD, he said.
Also, research has suggested that nicotine may be a co-promoter
in generating lung cancer, so continual exposure to nicotine might
work against chemotherapy treatments, Edelman said.
Given that more than 80 percent of some 200,000 lung cancer
cases diagnosed annually in the United States are smoking-related,
he said the complex dynamics of why so many smokers don't quit
needs to be better understood.
Even patients highly motivated to stop for good often need
substantial support, he added.
Weaver said the stressful period following diagnosis of lung
cancer can create a "teachable moment" for physicians, nurses and
other health care professionals to discuss smoking cessation with
the patient and family members, and offer encouragement and
resources to quit.
"My long term goal is to develop more effective interventions that can be delivered in the oncology setting, said Weaver.
Janine Cataldo, an assistant professor and researcher in
physiological nursing and gerontology at the University of
California San Francisco, is developing tools that measure the
quality of life and impact of social stigma on lung cancer patients
who continue smoking.
"For a smoker to have lung cancer and be unable to quit speaks to the power of nicotine addiction," said Cataldo. The average lung cancer patient is 55 years old and typically has tried and failed to quit smoking several times, she added.
Continued smoking has serious repercussions for lung cancer
patients, she said. Patients may develop appetite loss, fatigue,
cough or coughing up of blood, pain and poor sleep, said Cataldo.
Self-esteem suffers too, and anxiety and depression may also
develop, she said.
Cataldo is developing a six-month intervention that focuses on
three key components: nicotine replacement therapy to ease
withdrawal symptoms; a computerized calling system for monthly
phone counseling and weekly follow-up; and creation of a smoke-free
"The immediate benefits of quitting smoking are easier breathing, increased circulation and improved efficacy of cancer treatments," said Cataldo. "People find that once they quit, they have an increased joy of life, no matter how much they believed in the myth that they would miss cigarettes."
The U.S. Centers for Disease Control and Prevention lists
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