title: Is a cancer diagnosis a teachable moment for the patient's relative who smokes?
abstract: OBJECTIVE
  This study examined a cancer diagnosis, versus orthopedic surgery, as a teachable moment for recruiting smokers and treating nicotine dependence among patients' relatives.
  
  
  METHODS
  Cancer patients and, for comparison, orthopedic patients at the University of Pennsylvania Health System were approached for referrals of relatives for a smoking cessation program, which involved behavioral counseling and nicotine patches. Primary outcomes were rate of program enrollment and rate of smoking abstinence. Potential mediators of smoking cessation were explored (e.g., treatment adherence, depression, anxiety). Two hundred and thirty-four relatives (113 cancer, 121 orthopedic) were considered eligible for the cessation program and comprised the study sample.
  
  
  RESULTS
  Relatives of oncology patients were significantly more likely to enroll in the smoking cessation program, vs. orthopedic relatives (75 % vs. 60%; OR = 1.96, 95% CI 1.07-3.61, p = .03), but they were not significantly more likely to remain in the program (61% vs. 52%) or quit smoking (19% vs. 26%; p's > .05). Compared to orthopedic relatives, oncology relatives showed significantly lower nicotine patch adherence and significantly greater levels of negative affect and depression and anxiety symptoms during treatment (p's < .05). Further, orthopedic relatives, compared to oncology relatives, showed a greater reduction in the perceived benefits of smoking (p = .06), which was significantly associated with abstinence (p = .02).
  
  
  CONCLUSIONS
  While a family member's cancer diagnosis may serve as a teachable moment for a smoker to enroll in a smoking cessation treatment program, high levels of psychological distress and perceptions of the benefits of smoking and low levels of treatment adherence may undermine successful abstinence among this population.
authors.affiliation: Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA 19104, USA. schnoll@mail.med.upenn.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schnoll
authors.forename: E Paul
authors.initials: EP
authors.lastname: Wileyto
authors.forename: Frank T
authors.initials: FT
authors.lastname: Leone
authors.forename: Corey
authors.initials: C
authors.lastname: Langer
authors.forename: Richard
authors.initials: R
authors.lastname: Lackman
authors.forename: Tracey
authors.initials: T
authors.lastname: Evans
mesh_terms: D000328:Adult; D003376:Counseling; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012907:Smoking / Q000009:adverse effects / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology*