title: Post-operative smoking status in lung and head and neck cancer patients: association with depressive symptomatology, pain, and fatigue.
abstract: OBJECTIVE
  An estimated 35-50% of lung and head and neck cancer patients are smoking at diagnosis; most try to quit; however, a substantial proportion resumes smoking. As cancer treatments improve, attention to the effects of continued smoking on quality of life in the survivorship period is increasing. The current study examines if smoking abstinence following surgical treatment is associated with better quality of life.
  
  
  METHODS
  Participants were 134 patients with head and neck or lung cancer who received surgical treatment. Smoking status and indices of quality of life (depressive symptoms, fatigue, and pain) were assessed at the time of surgery (baseline) and at 2, 4, 6, and 12 months post-surgery. Analyses were performed using a generalized estimating equations approach. A series of models examined the correlation between smoking status and post-surgery quality of life while adjusting for demographics, clinical variables, and baseline smoking status and quality of life.
  
  
  RESULTS
  Continuous post-surgery abstinence was associated with lower levels of depressive symptoms and fatigue; however, the relationship with fatigue became nonsignificant after adjusting for baseline fatigue and income. There was no significant relationship observed between smoking status and pain.
  
  
  CONCLUSIONS
  Findings add to a growing literature showing that smoking cessation is not associated with detrimental effects on quality of life and may have beneficial effects, particularly with regard to depressive symptoms. Such information can be used to motivate smoking cessation and continued abstinence among cancer patients and increase provider comfort in recommending cessation.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.|Butler Hospital, Providence, RI, USA.
authors.forename: Erika Litvin
authors.initials: EL
authors.lastname: Bloom
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Oliver
authors.affiliation: Department of Psychology, University of South Florida, Tampa, FL, USA.|Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: Steven K
authors.initials: SK
authors.lastname: Sutton
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL, USA.|Department of Psychology, University of South Florida, Tampa, FL, USA.|Department of Oncologic Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: Vani Nath
authors.initials: VN
authors.lastname: Simmons
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000209:etiology* / Q000517:prevention & control; D005221:Fatigue / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D011184:Postoperative Period; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation; D013689:Telephone
keywords: head and neck cancer; lung cancer; quality of life; tobacco use