title: Changes in patterns of use of cigarettes and alcohol in women after a first diagnosis of invasive breast cancer: a cohort study of women from Victoria, Australia.
abstract: OBJECTIVE
  Smoking and alcohol consumption after breast cancer diagnosis have received little attention. The aim of this study was to describe the change in smoking and alcohol consumption of women in the BUPA Health Foundation Health and Wellbeing After Breast Cancer Study in the first 2 years after diagnosis.
  
  
  METHODS
  We documented cigarette and alcohol use at diagnosis in a prospective cohort study of 1,588 Australian women with invasive breast cancer in an enrolment questionnaire and again 2 years later (follow-up questionnaire, FQ1).
  
  
  RESULTS
  Twelve percent of participants smoked at diagnosis. Nearly one third of these had quit by FQ1 and of those continuing, 1 in 4 were smoking fewer cigarettes per day. Smoking more at diagnosis was significantly associated with smoking at FQ1.Over 70% of women reported consuming alcohol in each questionnaire. The proportion of women consuming more than four alcoholic drinks per occasion at least weekly dropped between the time of diagnosis and FQ1, although by FQ1, 1 in 12 women still reported this drinking pattern.
  
  
  CONCLUSIONS
  Smoking and alcohol consumption are important health issues for women with breast cancer. Health care providers should consider using evidence-based interventions to reduce smoking and drinking in this group.
authors.affiliation: Women's Health Program, School of Public Health and Preventive Medicine, Monash University, Level 6, 99 Commercial Rd, Melbourne 3004, VIC, Australia. robin.bell@monash.edu
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Bell
authors.forename: Marijana
authors.initials: M
authors.lastname: Lijovic
authors.forename: Pamela
authors.initials: P
authors.lastname: Fradkin
authors.forename: Max
authors.initials: M
authors.lastname: Schwarz
authors.forename: Susan R
authors.initials: SR
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014739:Victoria / Q000453:epidemiology