title: The role of second-hand smoke exposure on smoking cessation in non-tobacco-related cancers.
abstract: BACKGROUND
  Second-hand smoke (SHS) is a significant barrier to smoking cessation after a diagnosis of cancer in patients with lung as well as head and neck cancers. In the current study, the authors evaluated the effect of SHS on smoking cessation among patients with those cancers not traditionally perceived to be strongly associated with smoking.
  
  
  METHODS
  Patients recruited from a single tertiary care center completed a self-administered questionnaire. Multivariate logistic regression and Cox proportional hazards models evaluated the association of sociodemographics, clinicopathological variables, and exposure to SHS with either smoking cessation or time to quitting.
  
  
  RESULTS
  In all, 926 patients with diverse cancer subtypes completed the questionnaire. Of the 161 who were current smokers at the time of their cancer diagnosis, 48% quit after diagnosis. Lack of exposure to SHS at home was found to be associated with smoking cessation at any time after diagnosis (adjusted odd ratio, 4.28; 95% confidence interval, 1.56-11.78 [P =.005]), with similar trends noted 1 year after diagnosis (adjusted odds ratio, 2.56; 95% confidence interval, 0.91-7.22 [P =.08]). There was a significant inverse dose-response relationship between hours of SHS exposure at home and smoking cessation. Spousal and peer smoking were not found to be significantly associated with smoking cessation on multivariate analysis (P>.05). Kaplan-Meier analysis found that of patients who did quit smoking, 61% quit within 6 months of their cancer diagnosis.
  
  
  CONCLUSIONS
  Exposure to SHS at home is a significant barrier to smoking cessation in patients whose cancers are not traditionally perceived as being related to tobacco. SHS should be a key consideration in the development of survivorship programs geared toward smoking cessation for all patients with cancer.
authors: Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.|Ontario Cancer Institute, Toronto, Ontario, Canada.|Department of Medicine, University Health Network, Toronto, Ontario, Canada.
authors: Lawson
authors: L
authors: Eng
authors: Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.
authors: Xin
authors: X
authors: Qiu
authors: Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.
authors: Jie
authors: J
authors: Su
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Dan
authors: D
authors: Pringle
authors: Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.|Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Chongya
authors: C
authors: Niu
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Mary
authors: M
authors: Mahler
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Rebecca
authors: R
authors: Charow
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Jodie
authors: J
authors: Villeneuve
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Oleksandr
authors: O
authors: Halytskyy
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Christine
authors: C
authors: Lam
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Kyoko
authors: K
authors: Tiessen
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: M Catherine
authors: MC
authors: Brown
authors: Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.|Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Doris
authors: D
authors: Howell
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.|Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors: Meredith E
authors: ME
authors: Giuliani
authors: Ontario Cancer Institute, Toronto, Ontario, Canada.
authors: Jennifer M
authors: JM
authors: Jones
authors: Department of Medicine, University Health Network, Toronto, Ontario, Canada.
authors: Shabbir M H
authors: SM
authors: Alibhai
authors: Department of Otolaryngology-Head and Neck Surgery, University of Toronto, University Health Network, Toronto, Ontario, Canada.
authors: David P
authors: DP
authors: Goldstein
authors: Department of Biostatistics, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Wei
authors: W
authors: Xu
authors: Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.|Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors: Peter
authors: P
authors: Selby
authors: Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre/University Health Network and University of Toronto, Toronto, Ontario, Canada.|Ontario Cancer Institute, Toronto, Ontario, Canada.|Department of Medicine, University Health Network, Toronto, Ontario, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors: Geoffrey
authors: G
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution
keywords: cancer survivorship; second-hand smoke; smoking cessation; supportive care; teachable moment