title: Correlates of continued smoking versus cessation among survivors of smoking-related cancers.
abstract: OBJECTIVE
  We examined correlates of continued smoking versus cessation among a sample of survivors of smoking-related cancers who were actively smoking at the time of cancer diagnosis.
  
  
  METHODS
  Participants with a history of smoking and a smoking-related cancer diagnosis (lung, oral, pharynx, larynx, esophagus, bladder, stomach, cervix, kidney, pancreas, acute myeloid leukemia) within the past 4 years were identified in the electronic medical record. We recruited 613 individuals to complete a mail-based survey and received 139 completed surveys (22.7% response rate). We focused on 105 participants who smoked at the time of diagnosis and dichotomized them to having either quit since diagnosis (48.6%; n = 51) or continued smoking (51.4%; n = 54). We assessed sociodemographics, type of cancer and treatment(s), and psychosocial factors (depressive symptoms, social support, hope, quality of life). We then conducted structured interviews with a subset of 21 survey respondents.
  
  
  RESULTS
  Binary logistic regression indicated that, controlling for age, gender, ethnicity, marital status, and income, factors associated with continued smoking versus cessation included being diagnosed with other smoking-related cancers versus lung or head and neck cancer (OR = 11.21, CI 2.85, 44.02) and having significant depressive symptoms (OR = 1.25, CI 1.08, 1.45). Qualitative findings highlighted motivators for cessation (impact of being diagnosed with cancer, doctor advice to quit, social influences) and barriers to cessation (hopelessness, stress, addiction).
  
  
  CONCLUSIONS
  These findings highlight the need to address depressive symptoms among cancer survivors, particularly those continuing to smoke and the importance of exploring messages cancer survivors are given regarding the need for cessation post cancer diagnosis.
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA 30322, USA. cjberg@emory.edu
authors.forename: Carla J
authors.initials: CJ
authors.lastname: Berg
authors.forename: Akilah N
authors.initials: AN
authors.lastname: Thomas
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Schauer
authors.forename: Erika A
authors.initials: EA
authors.lastname: Pinsker
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
authors.forename: Fadlo R
authors.initials: FR
authors.lastname: Khuri
mesh_terms: D000368:Aged; D001294:Attitude to Health; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009369:Neoplasms / Q000139:chemically induced / Q000523:psychology*; D036301:Qualitative Research; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000523:psychology*; D012944:Social Support; D012959:Socioeconomic Factors; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*