title: A snapshot of smokers after lung and colorectal cancer diagnosis.
abstract: BACKGROUND
  Continued smoking after a cancer diagnosis may adversely affect treatment effectiveness, subsequent cancer risk, and survival. The prevalence of continued smoking after cancer diagnosis is understudied.
  
  
  METHODS
  In the multi-regional Cancer Care Outcomes Research and Surveillance cohort (lung cancer [N = 2456], colorectal cancer [N = 3063]), the authors examined smoking rates at diagnosis and 5 months after diagnosis and also study factors associated with continued smoking.
  
  
  RESULTS
  Overall, 90.2% of patients with lung cancer and 54.8% of patients with colorectal cancer reported ever smoking. At diagnosis, 38.7% of patients with lung cancer and 13.7% of patients with colorectal cancer were smoking; whereas, 5 months after diagnosis, 14.2% of patients with lung cancer and 9.0% of patients with colorectal cancer were smoking. Factors that were associated independently with continued smoking among patients with nonmetastatic lung cancer were coverage by Medicare, other public/unspecified insurance, not receiving chemotherapy, not undergoing surgery, prior cardiovascular disease, lower body mass index, lower emotional support, and higher daily ever-smoking rates (all P < .05). Factors that were associated independently with continued smoking among patients with nonmetastatic colorectal cancer were male sex, high school education, being uninsured, not undergoing surgery, and higher daily ever-smoking rates (all P < .05).
  
  
  CONCLUSIONS
  After diagnosis, a substantial minority of patients with lung and colorectal cancers continued smoking. Patients with lung cancer had higher rates of smoking at diagnosis and after diagnosis; whereas patients with colorectal cancer were less likely to quit smoking after diagnosis. Factors that were associated with continued smoking differed between lung and colorectal cancer patients. Future smoking-cessation efforts should examine differences by cancer type, particularly when comparing cancers for which smoking is a well established risk factor versus cancers for which it is not.
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. epark@partners.org
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Japuntich
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
authors.forename: Lara
authors.initials: L
authors.lastname: Traeger
authors.forename: Yulei
authors.initials: Y
authors.lastname: He
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Malin
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Zallen
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Keating
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation