Smoking Status Among Cancer Patients and its Impact on Health-related Quality of Life (HRQoL): A U.S Nationwide Representative Analysis.

Abstract

By 2023, an alarming 1,958,310 new cancer cases will arise across the United States.(1) To put things into perspective, in January 2019, 16.9 million people--roughly 5% of the population--were living with cancer in the USA.(2) Smoking is the leading risk factor for both cancer development and cancer mortality - over one-third (35%) of tobacco-related cancer cases can be linked back to smoking, and an alarming one-fifth of all cancers are directly attributable to this dangerous addiction.(3) Smoking contributes to the onset of cancer and detrimentally affects smokers' quality of life and life expectancy.(4)(5) Cancer patients often endure diminished quality of life alongside elevated mortality rates compared to the general population.(6)(7) Consequently, healthcare professionals must strive to prevent smoking within this susceptible population. Primary, secondary, and tertiary prevention strategies hold paramount importance and prove more efficient than addressing the aftermath of their shortcomings. The healthcare system typically focuses on treating specific illnesses as they arise, similar to "extinguishing fires," rather than proactively preventing diseases from occurring. Consequently, while preventive medicine should be the responsibility of all healthcare professionals, it frequently ends up being primarily shouldered by primary care practitioners. This unintentionally creates a setting where specialists might not give due weight to prevention within their particular areas of expertise. Despite the substantial efforts invested in creating groundbreaking cancer treatments, there remains a profoundly concerning disparity in the focus given to disease prevention initiatives. The widespread and harmful belief that irreversible damage is already done when a patient receives a cancer diagnosis, and any additional action would be pointless, can pose significant risks. This belief system hinders effective preventive measures and undermines the potential for positive change and improved health outcomes. Emphasizing the critical importance of disease prevention strategies implemented by all medical specialists is crucial. Brief interventions, including physician tobacco cessation guidance or referrals to specialized tobacco cessation programs, can significantly enhance patients' chances of survival and overall well-being. These seemingly minor measures can create a lasting, positive influence on the lives of those affected by tobacco-related health issues. Physicians hold a unique position to influence patient conduct through personalized interactions.(8) It is vital to intensify smoking cessation consciousness and provide physicians with the essential resources to assist their patients in triumphing over smoking.(9) This responsibility encompasses all medical practitioners, transcending primary care providers. Regrettably, the integration of smoking cessation counseling is not yet widespread among numerous physicians.(10)(11)(12)(13)(14)(15) In order to explore the prevailing circumstances of smoking cessation in cancer survivors and the impact of smoking behaviors on patients' HRQoL, we embarked on two interconnected research endeavors, drawing upon data from the Behavioral Risk Factor Surveillance System (BRFSS).(16) The CDC oversees this extensive and nationally representative database (Centers for Disease Control and Prevention). Our first paper examined the supposition that distinct medical specialties correlate with diverse tobacco cessation rates among tobacco-related cancer patients. We hypothesize that smoking prevalence among cancer survivors would diverge depending on the medical specialties involved in cancer care. In our second paper, we explored the relationship between the smoking habits of cancer survivors and their HRQoL. We hypothesized an existing link between a patient's smoking behavior and a decline in HRQoL, emphasizing the detrimental association of this particular risk factor with cancer survivors' well-being