Predictors of psychological distress in smokers diagnosed with cancer

Abstract

This study describes the characteristics of smokers diagnosed with tobacco-related cancers. The primary goal was to identify predictors of psychological distress of 188 smokers newly diagnosed with head and neck or lung cancer. Demographic data (gender, age, marital status, education, ethnicity, religion, income and employment status) were collected along with medical data (cancer site and cancer stage and physical symptoms assessed by the physical symptoms subscale of the Memorial Symptom Assessment Scale (MSAS). Also assessed were psychosocial and behavioral data such as lifetime prevalence of alcohol-related problems (CAGE), and mental health history. Monitoring coping style was assessed with the monitoring subscale of the Miller Behavioral Styles Scale (MBSS). Self reported smoking status was assessed as smoking even a puff within 48 hours prior to assessment. Psychological distress was assessed with the five-item Mental Health Index (MHI-5).;Overall rates of psychological distress in this sample were similar to that seen in the general population of cancer patients with 30.9% of participants reporting clinically significant psychological distress at baseline. Physical symptoms and smoking status emerged as the only significant predictors of psychological distress at baseline. Psychological distress declined from baseline to three-month follow-up, and leveled off by 12 months. No significant interactions between psychological distress over time and either cancer site, cancer stage, or smoking status at baseline were found.;In conclusion, we identified the key predictors for psychological distress at the time of diagnosis as current smoking and greater number of physical symptoms. Our finding illuminates the need to assess psychological distress of smokers diagnosed with cancer at the time of diagnosis. Since patients' smoking status is frequently available, because it is a part of nursing intake assessment in many hospitals, it is important to emphasize and follow-up patients who report current smoking after diagnosis.