title: Smoking and binge drinking among Canadian survivors of childhood and adolescent cancers: a comparative, population-based study.
abstract: BACKGROUND
  Objectives of this study were to describe the prevalence of smoking and binge drinking among survivors of childhood and adolescent cancer compared to controls who had never had cancer, and to identify factors associated with these behaviors.
  
  
  METHODS
  Data came from a national, multi-centre, population-based study of survivors of childhood and adolescent cancer (n = 1,263) aged 16 to 37 years and an age and gender matched control group (n = 1,422). Logistic regression analyses were performed to determine the likelihood and predictors of current smoking and binge drinking.
  
  
  RESULTS
  Survivors were less likely to be current smokers (OR(adj) = 0.65, 95% CI = 0.54-0.77) and binge drinkers (OR(adj) = 0.66, 95% CI = 0.55-0.78) than the controls. Still, a substantial proportion of survivors reported smoking (23%) and binge drinking (25%). Survivors' smoking and binge drinking did not vary substantially by the clinical factors assessed. Survivors who received therapy associated with cardiac and/or pulmonary toxicity were as likely to smoke as non-exposed survivors. For both the survivors and controls current smoking and binge drinking were associated with lower education and higher reported stress. Binge drinking was also associated with being male and life dissatisfaction in both groups.
  
  
  CONCLUSIONS
  This study indicates a need to reduce smoking and binge drinking among survivors of childhood and adolescent cancer and to design interventions addressing the underlying reasons for adopting unhealthy behaviors despite their risk for late effects. We identified factors related to smoking and binge drinking among survivors: being male, lower educational attainment, life dissatisfaction and high stress, which should help inform intervention development.
authors.affiliation: Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada, Ottawa, Ontario, Canada. kendra_carswell@phac-aspc.gc.ca
authors.forename: Kendra
authors.initials: K
authors.lastname: Carswell
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.forename: Rama C
authors.initials: RC
authors.lastname: Nair
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Shaw
authors.forename: Kathy N
authors.initials: KN
authors.lastname: Speechley
authors.forename: Maru
authors.initials: M
authors.lastname: Barrera
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Maunsell
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology*; D017741:Survivors