Social influences on smoking cessation in newly diagnosed cancer patients

Abstract

For patients undergoing treatment for cancer, smoking poses immediate risks of complications, diminished treatment success, and compromised recovery. Longer-term risks, including increased morbidity and mortality, are well documented. It has been repeatedly demonstrated in non-medically ill populations that supportive social influences, such as increased levels of positive cessation-specific social support, are positively associated with a smoker's likelihood of achieving abstinence. The types of social influences, however, and their implications on smoking cessation efforts by medically ill smokers remains unclear. This study examined the role of three kinds of social influences on smoking cessation and early maintenance in cancer patients: (1) support from a partner directly related to quitting, (2) partner smoking status, and (3) the presence of smokers in subjects' social networks. Newly diagnosed head and neck and lung cancer patients, who were married or living with a significant other (N = 113), were interviewed during hospitalization and at 3 months follow-up. At baseline, patients assessed expected support behavior frequencies, and at follow-up they assessed received support behavior frequencies. They also provided data on the smoking status of their partners, household members, and friends. At follow-up, 22% of patients relapsed. Subjects received lower levels of positive (helpful) and negative (hindering) support behaviors than they expected. Participants who received fewer negative support behaviors from their partners were more likely to be successful continuous abstainers at follow-up. At baseline, 55% of patients reported having a partner who was either actively smoking or had quit during the past 6 months. When the recency of partners' smoking cessation was considered, a significantly higher proportion of relapsers, compared to continuous abstainers, had partners who were either baseline active smokers or recent quitters. These findings suggest that patients expect more quitting support than they receive, and that higher levels of experienced negative support behaviors, as well as having a partner who is actively smoking or has recently quit, are hindrances to attempts to maintain abstinence. Implications for potential social interventions to bolster smoking cessation efforts are discussed.