Tobacco smoking is causally related to at least 12 cancers types. Although the strongest causal links have been found for lung and head and neck (H&N) cancers, other cancers have a moderate causal link. Cancer diagnosis often motivates patients to quit smoking, but more than one third continue to smoke. The majority of smoking cessation studies have focused on patients with the cancers most directly associated with smoking: lung and H&N. This is logical, given that smoking prevalence is highest among these cancer patients, and research (including our preliminary study) indicates that they are the most motivated and most likely to quit smoking. However, across cancer types, continued smoking after diagnosis carries multiple risks with respect to cancer treatment efficacy, treatment complications, development of second primary tumors, and cancer recurrence. Thus, regardless of cancer type, smoking cessation is critically important for cancer patients. Therefore, there is an urgent need to extend smoking cessation motivation and behavior change interventions to include patients with cancers across the cancer spectrum, particularly those with cancers that the public does not readily associate with smoking.
The aim of this project is to capitalize on the ?teachable moment? of cancer diagnosis to develop and pilot a brief, easily-disseminated intervention to increase cessation motivation for recently diagnosed patients with a cancer not widely known to be associated with smoking (i.e., those with moderate or unknown smoking-related etiology). We will conduct two rigorous studies, initially focusing on breast, colorectal, gynecological, skin melanoma, and bladder cancer types. In Study I, based on the Teachable Moment Model, we will create separate targeted self-help interventions in the form of booklets/pamphlets for each of these five cancer types. We will follow a three-phase process: (1) qualitative assessment to collect data on smoking cessation and cessation motivation among representative cancer patients; (2) development of the content of the intervention based on Phase 1 results; (3) testing the initial draft of the intervention with the target population and modifying based on feedback. After the intervention is developed, Study II will assess its feasibility and acceptability by distributing the new booklets/pamphlets to cancer patients who are current smokers and have been diagnosed with one of the five cancer types (N=50). In addition to feasibility and acceptability, we will collect indices of changes in cessation motivation and behavior. These data will provide valuable information for a subsequent, fully-powered randomized controlled smoking cessation trial. Given the clinical importance of smoking cessation to all cancer patients, this research has potential for wide impact upon cancer treatment outcomes and quality of life.
Although patients diagnosed with lung and head and neck cancers are often motivated to quit smoking, those with other cancers tend to be less motivated. This study will develop brief self-help materials designed to help other cancer patients understand the relevance of smoking upon their cancer, its successful treatment, and their recovery. The goal is to increase motivation to quit smoking, and ultimately smoking cessation itself, among a wide spectrum of cancer patients.