title: Second-hand smoke as a predictor of smoking cessation among lung cancer survivors.
abstract: OBJECTIVE
  Second-hand smoke (SHS; ie, exposure to smoking of friends and spouses in the household) reduces the likelihood of smoking cessation in noncancer populations. We assessed whether SHS is associated with cessation rates in lung cancer survivors.
  
  
  METHODS
  Patients with lung cancer were recruited from Princess Margaret Cancer Centre, Toronto, ON, Canada. Multivariable logistic regression and Cox proportional hazard models evaluated the association of sociodemographics, clinicopathologic variables, and SHS with either smoking cessation or time to quitting.
  
  
  RESULTS
  In all, 721 patients completed baseline and follow-up questionnaires with a mean follow-up time of 54 months. Of the 242 current smokers at diagnosis, 136 (56%) had quit 1 year after diagnosis. Exposure to smoking at home (adjusted odds ratio [aOR], 6.18; 95% CI, 2.83 to 13.5; P < .001), spousal smoking (aOR, 6.01; 95% CI, 2.63 to 13.8; P < .001), and peer smoking (aOR, 2.49; 95% CI, 1.33 to 4.66; P = .0043) were each associated with decreased rates of cessation. Individuals exposed to smoking in all three settings had the lowest chances of quitting (aOR, 9.57; 95% CI, 2.50 to 36.64; P < .001). Results were similar in time-to-quitting analysis, in which 68% of patients who eventually quit did so within 6 months after cancer diagnosis. Subgroup analysis revealed similar associations across early- and late-stage patients and between sexes.
  
  
  CONCLUSIONS
  SHS is an important factor associated with smoking cessation in lung cancer survivors of all stages and should be a key consideration when developing smoking cessation programs for patients with lung cancer.
authors.affiliation: Lawson Eng, Jie Su, Xin Qiu, Prakruthi R. Palepu, Henrique Hon, Ehab Fadhel, Luke Harland, Anthony La Delfa, Steven Habbous, Aidin Kashigar, Sinead Cuffe, Frances A. Shepherd, Natasha B. Leighl, Andrew F. Pierre, David P. Goldstein, Wei Xu, and Geoffrey Liu, Princess Margaret Hospital/Ontario Cancer Institute/University Health Network, University of Toronto; Peter Selby, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Lawson
authors.initials: L
authors.lastname: Eng
authors.forename: Jie
authors.initials: J
authors.lastname: Su
authors.forename: Xin
authors.initials: X
authors.lastname: Qiu
authors.forename: Prakruthi R
authors.initials: PR
authors.lastname: Palepu
authors.forename: Henrique
authors.initials: H
authors.lastname: Hon
authors.forename: Ehab
authors.initials: E
authors.lastname: Fadhel
authors.forename: Luke
authors.initials: L
authors.lastname: Harland
authors.forename: Anthony
authors.initials: A
authors.lastname: La Delfa
authors.forename: Steven
authors.initials: S
authors.lastname: Habbous
authors.forename: Aidin
authors.initials: A
authors.lastname: Kashigar
authors.forename: Sinead
authors.initials: S
authors.lastname: Cuffe
authors.forename: Frances A
authors.initials: FA
authors.lastname: Shepherd
authors.forename: Natasha B
authors.initials: NB
authors.lastname: Leighl
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Pierre
authors.forename: Peter
authors.initials: P
authors.lastname: Selby
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017741:Survivors; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution