Knowledge of the harms of tobacco use among patients with bladder cancer.
BACKGROUND
The objective of this study was to determine tobacco use knowledge and attribution of cause in patients with newly diagnosed bladder cancer.


METHODS
A stratified, random sample of bladder cancer survivors diagnosed between 2006 and 2009 was obtained from the California Cancer Registry. Respondents were surveyed about tobacco use, risk factors, and sources of information on the causes of bladder cancer. Contingency tables and logistic regression analyses were used to evaluate tobacco use knowledge and beliefs.


RESULTS
Of 1198 eligible participants, 790 (66%) completed the survey. Sixty-eight percent of the cohort had a history of tobacco use, and 19% were active smokers at diagnosis. Tobacco use was the most cited risk factor for bladder cancer, with active smokers more knowledgeable than former smokers or never smokers (90% vs 64% vs 61%, respectively; P<.001). Urologists were the predominant source of information and were cited most often by active smokers (82%). In multivariate analyses, active smokers had 6.37 times greater odds (95% confidence interval, 3.35-12.09) than never smokers of endorsing tobacco use as a risk factor for bladder cancer, and smokers who named the urologist as their information source had 2.80 times greater odds (95% confidence interval, 1.77-4.43) of believing tobacco use caused their cancer.


CONCLUSIONS
Patients' smoking status and primary source of information were associated with knowledge of the harms of tobacco use and, in smokers, acknowledgment that tobacco use increased the risk of their own disease. Urologists play a critical role in ensuring patients' knowledge of the connection between smoking and bladder cancer, particularly for active smokers who may be motivated to quit.
Department of Health Services, University of California-Los Angeles, Los Angeles, California; Department of Urologic Surgery, Vanderbilt University, Nashville, Tennessee; Department of Urology, Kaiser Permanente Southern California, Orange County.
Jeffrey C
JC
Bassett
John L
JL
Gore
Lorna
L
Kwan
Chad R
CR
Ritch
Daniel A
DA
Barocas
David F
DF
Penson
William J
WJ
McCarthy
Christopher S
CS
Saigal
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016540:Smoking Cessation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D064424:Tobacco Use / Q000009:adverse effects*; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology; D001749:Urinary Bladder Neoplasms / Q000209:etiology* / Q000523:psychology*
and practice; attitudes; awareness; bladder cancer; causality; health knowledge; patient education; questionnaires; risk factors; smoking/adverse effects; smoking/epidemiology; tobacco use