A five-year program integrating didactic and supervised research experience in oncology behavioral is proposed. This award will provide the applicant with intensive training under the expert guidance of scientists in the field.
The specific aims of the application are to 1) enhance knowledge and skills in interdisciplinary cancer prevention and control research by obtaining further training in behavioral oncology, 2) enhance clinical and research skills to include providing advice to promote smoking cessation among smokers, and gain experience in the measurement and analyses of variables important in tobacco research, and 3) conduct research in collaboration with experts in nicotine and tobacco, psychosocial, behavioral, and thoracic/head and neck oncology. The program of study will include course work, seminars, and a clinical and research practicum. The research plan is designed to provide practical experience in conducting research in behavioral oncology. The objectives of the proposed research are to estimate point prevalence and continued abstinence rates among adults with cancer, describe smoking cessation interventions used by adults with cancer and identify factors related to smoking relapse among adults with cancer who have quit smoking. Smoking cessation after the diagnosis of cancer is associated with an improved response to treatment, decrease in treatment related side effects, decrease in second primary malignancies, and improved survival. The time surrounding the diagnosis of a life threatening illness presents a unique opportunity to change smoking behaviors. The frequency of health care encounters in combination with a smokers increased awareness of the illness related effects of tobacco provide an opportune time to initiate smoking cessation interventions. Issues related to smoking behaviors have been largely ignored in adults with cancer. Because lung and head and neck cancer are the most common smoking related malignancies, these two cancer sites will be the focus for the study. No prospective studies using biochemical verification of smoking status have been done in adults with lung cancer, whereas only one study was conducted in adults with head and neck cancer. Moreover, there is scant information available about factors affecting relapse in ismokers with cancer. The results from the proposed research will provide information needed to develop !interventions and to target those who need more intensive smoking cessation interventions.