title: Social environment, secondary smoking exposure, and smoking cessation among head and neck cancer patients.
abstract: BACKGROUND
  Smoking during treatment of squamous cell head and neck cancer (HNC) has adverse affects on toxicity, treatment, and survival. The purpose of this report was to evaluate sociodemographic predictors of smoking cessation in HNC patients to support the development of a smoking cessation program.
  
  
  METHODS
  Newly diagnosed HNC patients (2007-2010) at Princess Margaret Cancer Centre treated with curative intent were prospectively recruited. Patients completed self-reported baseline and follow-up questionnaires, assessing changes in social habits. Predictors of smoking cessation and time to quitting were evaluated using logistic regression and Cox proportional hazard models, respectively.
  
  
  RESULTS
  Of 295 HNC patients, 49% were current smokers at diagnosis, and 50% quit after diagnosis. These individuals were more likely to have smoked for fewer years (P = .0003), never used other forms of tobacco (P = .0003), and consumed less alcohol (P = .002). No cigarette exposure at home (OR, 7.44 [3.04-18.2]), no spousal smoking (OR, 4.25 [1.70-10.6]), and having fewer friends who smoke (OR, 2.32 [1.00-5.37]) were consistent predictors of smoking cessation after diagnosis. Having none of these exposures (OR, 13.8 [4.13-46.0]) and seeing a family physician (OR, 3.92 [1.38-11.2]) were independently associated with smoking cessation and time-to-quitting analyses. Most HNC patients (68%) quit within 6 months of diagnosis. Patients who were ex-smokers at diagnosis were older (P < .0001), more likely to be female (P = .0002), more likely to be married (P = .0004), more educated (P = .01), and had fewer pack-years of smoking (P < .0001).
  
  
  CONCLUSIONS
  Spousal smoking, peer smoking, smoke exposure at home, and seeing a family physician were strongly and consistently associated with smoking cessation and time to quitting after a HNC diagnosis.
authors.affiliation: Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Aidin
authors.initials: A
authors.lastname: Kashigar
authors.forename: Steven
authors.initials: S
authors.lastname: Habbous
authors.forename: Lawson
authors.initials: L
authors.lastname: Eng
authors.forename: Brendan
authors.initials: B
authors.lastname: Irish
authors.forename: Eric
authors.initials: E
authors.lastname: Bissada
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
authors.forename: Dale
authors.initials: D
authors.lastname: Brown
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Shao-Hui
authors.initials: SH
authors.lastname: Huang
authors.forename: Ian
authors.initials: I
authors.lastname: Witterick
authors.forename: Jeremy
authors.initials: J
authors.lastname: Freeman
authors.forename: Brian
authors.initials: B
authors.lastname: O'Sullivan
authors.forename: John
authors.initials: J
authors.lastname: Waldron
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution
keywords: head and neck cancer; passive smoking; self-report; smoking cessation; social environment