title: Smoking relapse during the first year after treatment for early-stage non-small-cell lung cancer.
abstract: BACKGROUND
  Non-small-cell lung cancer patients who continue to smoke after cancer diagnosis are more likely to experience disease recurrence, decreased treatment efficacy, and treatment complications. Despite this, many continue to smoke, with estimates ranging from 13% to approximately 60%.
  
  
  METHODS
  Participants were 154 early-stage, non-small-cell lung cancer patients who had smoked within 3 months before surgery. Patients were followed for 12 months after surgery to assess smoking status and duration of continuous abstinence after surgery. Predictors included medical, smoking history, psychosocial, and demographic characteristics.
  
  
  RESULTS
  At some point after surgery, 42.9% of patients smoked; at 12 months after surgery, 36.9% were smoking. Sixty percent of patients who lapsed did so during the first 2 months after surgery. Smoking at follow-up was predicted by shorter quit duration before surgery, more intense Appetitive cravings (expectation of pleasure from smoking), lower income, and having a higher level of education. Time until the first smoking lapse was predicted by shorter quit duration before surgery, more intense Appetitive cravings to smoke, and lower income. Among those who lapsed, greater delay before the lapse was associated with abstinence at the 12-month follow-up assessment.
  
  
  CONCLUSIONS
  Nearly half of non-small-cell lung cancer patients return to smoking after surgery if they have recent smoking histories. Most initial lapses happen within 2 months and occur in response to more recent smoking and more intense cravings. Findings suggest that interventions to prevent relapse should target those who wait until cancer surgery to quit smoking and should be started as soon as possible after treatment.
authors.affiliation: Department of Medicie, Washingon University School of Medicine, St. Louis, Missouri, USA. mwalker@im.wustl.edu
authors.forename: Mark S
authors.initials: MS
authors.lastname: Walker
authors.forename: Damon J
authors.initials: DJ
authors.lastname: Vidrine
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Larsen
authors.forename: Yan
authors.initials: Y
authors.lastname: Yan
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Govindan
authors.forename: Edwin B
authors.initials: EB
authors.lastname: Fisher
mesh_terms: D001294:Attitude to Health; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000523:psychology; D013997:Time Factors; D014029:Tobacco Use Disorder / Q000517:prevention & control / Q000523:psychology; D014481:United States / Q000453:epidemiology