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Journal of Cancer Survivorship
Published in: Journal of Cancer Survivorship 2/2019

01-04-2019 | Smoking and Nicotine Detoxification

Dual cigarette and e-cigarette use in cancer survivors: an analysis using Population Assessment of Tobacco Health (PATH) data

Authors: Yael R. Symes, Kurt M. Ribisl, Marcella H. Boynton, J. Lee Westmaas, Deborah K. Mayer, Shelley D. Golden

Published in: Journal of Cancer Survivorship | Issue 2/2019

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Abstract

Purpose

Cancer survivors who smoke cigarettes face health risks from continued smoking. Some smokers use e-cigarettes to reduce combustible cigarette use, but research on whether cancer survivors do the same is limited. Research is needed to understand whether smokers who are cancer survivors use e-cigarettes at higher rates than smokers never diagnosed with cancer, to inform provider-patient discussions about e-cigarettes.

Methods

Using cross-sectional data from current cigarette smokers in Wave 1 (2013–2014) of the Population Assessment of Tobacco Health (PATH) study, we compared cancer survivors (n = 433) and those without a prior cancer diagnosis (n = 10,872) on e-cigarette use and reasons for use.

Results

Among smokers, 59.4% of cancer survivors and 63.2% of those without a cancer diagnosis had ever used e-cigarettes, and nearly one-quarter of both groups (23.1% and 22.3%, respectively) reported being current users. Multivariate results, however, suggest that cancer survivors might be more likely to be ever (OR = 1.28; p = .05) or current (OR = 1.25; p = .06) e-cigarette users compared to those never diagnosed, although results were marginally significant. The majority of both groups (> 71%) reported using e-cigarettes for perceived health-related reasons—including smoking reduction.

Conclusions

Our study found that among smokers, cancer survivors were using e-cigarettes at similar rates as never-diagnosed smokers and both groups used e-cigarettes largely for perceived health-related reasons.

Implications for cancer survivors

Clinicians who treat cancer survivors may need to routinely ask their patients who smoke about e-cigarette use and address the limited research on the efficacy of e-cigarettes as a cessation aid as compared to other evidence-based options.
Literature
1.
Cox LS, Africano NL, Tercyak KP, Taylor KL. Nicotine dependence treatment for patients with cancer. Cancer. 2003;98(3):632–44.CrossRefPubMed
2.
Berg CJ, Thomas AN, Mertens AC, Schauer GL, Pinsker EA, Ahluwalia JS, et al. Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Psycho-Oncology. 2013;22(4):799–806.CrossRefPubMed
3.
4.
Warren GW, Kasza KA, Reid ME, Cummings KM, Marshall JR. Smoking at diagnosis and survival in cancer patients. Int J Cancer. 2013;132(2):401–10.CrossRefPubMed
5.
Cooley ME, Lundin R, Murray L. Smoking cessation interventions in cancer care: opportunities for oncology nurses and nurse scientists. Annu Rev Nurs Res. 2009;27(1):243–72.CrossRefPubMedPubMedCentral
6.
Mayer DK, Terrin NC, Menon U, Kreps GL, McCance K, Parsons SK, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007;34(3):643–51.CrossRefPubMed
7.
Coups EJ, Dhingra LK, Heckman CJ, Manne SL. Receipt of provider advice for smoking cessation and use of smoking cessation treatments among cancer survivors. J Gen Intern Med. 2009;24(2):480–6.CrossRefPubMedCentral
8.
Underwood JM, Townsend JS, Tai E, White A, Davis SP, Fairley TL. Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis. J Cancer Surviv. 2012;6(3):333–44.CrossRefPubMedPubMedCentral
9.
Bellizzi KM, Rowland JH, Jeffery DD, McNeel T. Health behaviors of cancer survivors: examining opportunities for cancer control intervention. J Clin Oncol. 2005;23(34):8884–93.CrossRefPubMed
10.
Tseng T-S, Lin H-Y, Moody-Thomas S, Martin M, Chen T. Who tended to continue smoking after cancer diagnosis: the national health and nutrition examination survey 1999–2008. BMC Public Health. 2012;12(1):784.CrossRefPubMedPubMedCentral
11.
Fox JL, Rosenzweig KE, Ostroff JS. The effect of smoking status on survival following radiation therapy for non-small cell lung cancer. Lung Cancer. 2004;44(3):287–93.CrossRefPubMed
12.
Videtic GM, Stitt LW, Dar AR, et al. Continued cigarette smoking by patients receiving concurrent chemoradiotherapy for limited-stage small-cell lung cancer is associated with decreased survival. J Clin Oncol. 2003;21(8):1544–9.CrossRefPubMed
13.
Johnson BE. Second lung cancers in patients after treatment for an initial lung cancer. J Natl Cancer Inst. 1998;90(18):1335–45.CrossRefPubMed
14.
Do K-A, Johnson MM, Doherty DA, Lee JJ, Wu XF, Dong Q, et al. Second primary tumors in patients with upper aerodigestive tract cancers: joint effects of smoking and alcohol (United States). Cancer Causes Control. 2003;14(2):131–8.CrossRefPubMed
15.
Khuri FR, Kim ES, Lee JJ, et al. The impact of smoking status, disease stage, and index tumor site on second primary tumor incidence and tumor recurrence in the head and neck retinoid chemoprevention trial. Cancer Epidemiol Biomark Prev. 2001;10(8):823–9.
16.
Rice D, Kim H-W, Sabichi A, Lippman S, Lee JJ, Williams B, et al. The risk of second primary tumors after resection of stage I nonsmall cell lung cancer. Ann Thorac Surg. 2003;76(4):1001–8.CrossRefPubMed
17.
Richardson GE, Tucker MA, Venzon DJ, Linnoila RI, Phelps R, Phares JC, et al. Smoking cessation after successful treatment of small-cell lung cancer is associated with fewer smoking-related second primary cancers. Ann Intern Med. 1993;119(5):383–90.CrossRefPubMed
18.
Tucker MA, Murray N, Shaw EG, Ettinger DS, Mabry M, Huber MH, et al. Second primary cancers related to smoking and treatment of small-cell lung cancer. J Natl Cancer Inst. 1997;89(23):1782–8.CrossRefPubMed
19.
Browman GP, Wong G, Hodson I, Sathya J, Russell R, McAlpine L, et al. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. New Engl J Med. 1993;328(3):159–63.CrossRefPubMed
20.
Møller A, Pedersen T, Villebro N, Schnaberich A, Haas M, Tønnesen R. A study of the impact of long-term tobacco smoking on postoperative intensive care admission. Anaesthesia. 2003;58(1):55–9.CrossRefPubMed
21.
Peppone LJ, Mustian KM, Morrow GR, Dozier AM, Ossip DJ, Janelsins MC, et al. The effect of cigarette smoking on cancer treatment–related side effects. Oncologist. 2011;16(12):1784–92.CrossRefPubMedPubMedCentral
22.
Vaporciyan AA, Merriman KW, Ece F, Roth JA, Smythe WR, Swisher SG, et al. Incidence of major pulmonary morbidity after pneumonectomy: association with timing of smoking cessation. Ann Thorac Surg. 2002;73(2):420–6.CrossRefPubMed
23.
Karam-Hage M, Cinciripini PM, Gritz ER. Tobacco use and cessation for cancer survivors: an overview for clinicians. CA Cancer J Clin. 2014;64(4):272–90.CrossRefPubMedPubMedCentral
24.
25.
Rutten LJF, Blake KD, Agunwamba AA, Grana RA, Wilson PM, Ebbert JO, et al. Use of e-cigarettes among current smokers: associations among reasons for use, quit intentions, and current tobacco use. Nicotine Tob Res. 2015;17(10):1228–34.CrossRefPubMedPubMedCentral
26.
Zhuang Y-L, Cummins SE, Sun JY, Zhu S-H. Long-term e-cigarette use and smoking cessation: a longitudinal study with US population. Tob Control. 2016;25(Suppl 1):i90–5.CrossRefPubMed
27.
Salloum RG, Getz KR, Tan AS, et al. Use of electronic cigarettes among cancer survivors in the US. Am J Prev Med. 2016;51(5):762–6.CrossRefPubMed
28.
29.
American Cancer Society. Cancer facts and figures 2017. Atlanta: American Cancer Society; 2017.
30.
Delnevo CD, Giovenco DP, Steinberg MB, Villanti AC, Pearson JL, Niaura RS, et al. Patterns of electronic cigarette use among adults in the United States. Nicotine Tob Res. 2016;18(5):715–9.CrossRefPubMed
31.
McMillen RC, Gottlieb MA, Shaefer RMW, Winickoff JP, Klein JD. Trends in electronic cigarette use among US adults: use is increasing in both smokers and nonsmokers. Nicotine Tob Res. 2015;17(10):1195–202.CrossRefPubMed
32.
McQueen N, Partington EJ, Harrington KF, Rosenthal EL, Carroll WR, Schmalbach CE. Smoking cessation and electronic cigarette use among head and neck cancer patients. Otolaryngol Head Neck Surg. 2016;154(1):73–9.CrossRefPubMed
33.
Borderud SP, Li Y, Burkhalter JE, Sheffer CE, Ostroff JS. Electronic cigarette use among patients with cancer: characteristics of electronic cigarette users and their smoking cessation outcomes. Cancer. 2014;120(22):3527–35.CrossRefPubMed
34.
Kalkhoran S, Glantz SA. E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. Lancet Respir Med. 2016;4(2):116–28.CrossRefPubMedPubMedCentral
35.
Pepper JK, Brewer NT. Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review. Tob Control. 2014;23(5):375–84.CrossRefPubMed
36.
37.
Malas M, van der Tempel J, Schwartz R, Minichiello A, Lightfoot C, Noormohamed A, et al. Electronic cigarettes for smoking cessation: a systematic review. Nicotine Tob Res. 2016;18(10):1926–36.CrossRefPubMed
38.
39.
40.
Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet. 2013;382(9905):1629–37.CrossRefPubMed
41.
42.
Nayan S, Gupta MK, Strychowsky JE, Sommer DD. Smoking cessation interventions and cessation rates in the oncology population an updated systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2013;149(2):200–11.CrossRefPubMed
43.
44.
Brandon TH, Goniewicz ML, Hanna NH, Hatsukami DK, Herbst RS, Hobin JA, et al. Electronic nicotine delivery systems: a policy statement from the American Association for Cancer Research and the American Society of Clinical Oncology. J Clin Oncol. 2015;33(8):952–63.CrossRefPubMed
45.
46.
Travis LB. The epidemiology of second primary cancers. Cancer Epidemiol Biomark Prev. 2006;15(11):2020–6.CrossRef
47.
Hyland A, Ambrose BK, Conway KP, Borek N, Lambert E, Carusi C, et al. Design and methods of the Population Assessment of Tobacco and Health (PATH) study. Tob Control. 2016;26(4):371–8.CrossRefPubMed
48.
Secretan B, Straif K, Baan R, Grosse Y, el Ghissassi F, Bouvard V, et al. A review of human carcinogens—part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncol. 2009;10(11):1033–4.CrossRefPubMed
49.
Westmaas JL, Alcaraz KI, Berg CJ, Stein KD. Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis. Cancer Epidemiol Biomark Prev. 2014;23(9):1783–92.CrossRef
50.
Hanna N, Mulshine J, Wollins DS, Tyne C, Dresler C. Tobacco cessation and control a decade later: American Society of Clinical Oncology policy statement update. J Clin Oncol. 2013;31(25):3147–57.CrossRefPubMed
Metadata
Title
Dual cigarette and e-cigarette use in cancer survivors: an analysis using Population Assessment of Tobacco Health (PATH) data
Authors
Yael R. Symes
Kurt M. Ribisl
Marcella H. Boynton
J. Lee Westmaas
Deborah K. Mayer
Shelley D. Golden
Publication date
01-04-2019
Publisher
Springer US
Published in
Journal of Cancer Survivorship / Issue 2/2019
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-019-0735-y

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