title: The relationship between smoking and quality of life in advanced lung cancer patients: a prospective longitudinal study.
abstract: OBJECTIVE
  Smoking is a major cause of lung cancer, and continued smoking may compromise treatment efficacy and quality of life (health-related quality of life (HRQoL)) in patients with advanced lung cancer. Our aims were to determine (i) preference for treatments which promote quality over length of life depending on smoking status, (ii) the relationship between HRQoL and smoking status at diagnosis (T1), after controlling for demographic and clinical variables, and (iii) changes in HRQoL 6 months after diagnosis (T2) depending on smoking status.
  
  
  METHODS
  Two hundred ninety-six patients with advanced lung cancer were given questionnaires to assess HRQoL (EORTC QLQ-C30), time-trade-off for life quality versus quantity (QQQ) and smoking history (current, former or never smoker) at diagnosis (T1) and 6 months later (T2). Medical data were extracted from case records.
  
  
  RESULTS
  Questionnaires were returned by 202 (68.2 %) patients at T1 and 114 (53.3 %) at T2. Patients favoured treatments that would enhance quality of life over increased longevity. Those who continued smoking after diagnosis reported worse HRQoL than former smokers or those who never smoked. Smoking status was a significant independent predictor of coughing in T1 (worse in smokers) and cognitive functioning in T2 (better in never smokers).
  
  
  CONCLUSIONS
  Smoking by patients with advanced lung cancer is associated with worse symptoms on diagnosis and poorer HRQoL for those who continue smoking. The results have implications to help staff explain the consequences of smoking to patients.
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, Whitham Road, Sheffield, S10 2SJ, UK. s.danson@shef.ac.uk.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Danson
authors.affiliation: Manchester Centre for Health Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Rowland
authors.affiliation: Department of Psychology, University of Sheffield, Sheffield, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Rowe
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, Whitham Road, Sheffield, S10 2SJ, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Ellis
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, Whitham Road, Sheffield, S10 2SJ, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Crabtree
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, Whitham Road, Sheffield, S10 2SJ, UK.
authors.forename: Janet M
authors.initials: JM
authors.lastname: Horsman
authors.affiliation: Department of Oncology, Weston Park Hospital, Sheffield, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wadsley
authors.affiliation: Department of Oncology, Weston Park Hospital, Sheffield, UK.
authors.forename: Matthew Q
authors.initials: MQ
authors.lastname: Hatton
authors.affiliation: Academic Unit of Clinical Oncology, University of Sheffield, Whitham Road, Sheffield, S10 2SJ, UK.
authors.forename: Penella J
authors.initials: PJ
authors.lastname: Woll
authors.affiliation: Department of Psychology, University of Sheffield, Sheffield, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Eiser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: Lung cancer; Quality of life; Smoking; Smoking cessation