title: Effect of cigarette smoking on quality of life in small cell lung cancer patients.
abstract: BACKGROUND
  Continued cigarette smoking after small cell lung cancer (SCLC) diagnosis has been shown to shorten patients' survival, but little is known about the impact of smoking and cessation on quality of life (QOL) profile (e.g., overall QOL, pain, fatigue, cough, dyspnea, appetite change, and performance status) in SCLC survivors (who survived at least 6 months post initial diagnosis). In this study, we sought to evaluate the relationship between cigarette smoking and QOL profiles in SCLC patients.
  
  
  METHODS
  A total of 223 survivors were classified into five groups: never smokers, former smokers (quit more than 1 year prior to diagnosis), recent quitters (quit within 1 year surrounding diagnosis), late quitters (quit after 1 year post diagnosis) and never quitters. One hundred and sixty-eight of these survivors were matched with 334 lung-cancer-free controls on age, gender, and smoking status for comparative analysis. QOL scales were scored from 0 (worse) to 100 (best). Conditional logistic regression, linear mixed-effect models, and Wilcoxon signed rank tests were used.
  
  
  RESULTS
  SCLC survivors consistently showed a significant deficit in QOL profile; e.g., mean overall QOL in patients was 17.5 points worse than the controls (p<0.0001). Among all smokers, former smokers reported the best QOL profile, while late or never quitters reported the worst. The recent quitters showed an improving trend in QOL profile and lower percent of reduced appetite (an average of 43%) compared to the late or never quitters (58%).
  
  
  CONCLUSIONS
  Our study confirmed the negative impact of smoking on SCLC survivors' QOL and found that smoking cessation surrounding the time of diagnosis could improve overall QOL and symptoms. The findings of this study provide evidence for oncologists to recommend smoking cessation to their SCLC patients.
authors.affiliation: Department of Medical Oncology, The Second Affiliated Hospital, Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian 116023, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.forename: Yingwei
authors.initials: Y
authors.lastname: Qi
authors.forename: Jason A
authors.initials: JA
authors.lastname: Wampfler
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: Yolanda I
authors.initials: YI
authors.lastname: Garces
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Busta
authors.forename: Sumithra J
authors.initials: SJ
authors.lastname: Mandrekar
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough; D004417:Dyspnea; D005221:Fatigue; D005260:Female; D006801:Humans; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D010146:Pain; D011788:Quality of Life; D055752:Small Cell Lung Carcinoma / Q000150:complications / Q000523:psychology*; D012907:Smoking; D016540:Smoking Cessation; D017741:Survivors; D013997:Time Factors