Abstract
Background: Continued smoking after a cancer diagnosis is associated with poorer outcomes. As smoking cessation is an important part of cancer care, understanding cancer patient (pt) attitudes towards smoking status assessment will help with integrating smoking cessation programs into cancer care. Methods: Cancer pts from all subtypes were surveyed on their smoking history, assessment rates and attitudes/preferences towards smoking status assessment. Multivariate logistic regression models helped assess for factors associated with screening preferences. Results: Among 501 pts, 115 smoked at diagnosis and 60% quit after; 53% had a tobacco related (lung/head and neck) cancer (TRC); 64% were treated curatively; 40% reported that their smoking status was assessed only on their first clinic visit, while 32% were assessed at a few visits and 12% all visits. Most felt that smoking status should be assessed at the first visit (95%), while half (58%) felt it should be assessed every visit. Most felt comfortable with being assessed (96%), felt it was important for clinicians to be aware of smoking status (98%) and that smoking cessation discussions should occur at the first visit (87%). Most preferred being assessed by their oncologist (88%); less than half preferred being asked by another healthcare provider (44%), on paper (29%) or electronic surveys (32%). When compared to ex/never smokers, current smokers were assessed more often at every/most visits (36% vs 20% P = 0.001); fewer felt assessment should occur at the first visit (89% vs 97% P = 0.008) and were less comfortable with being assessed (88% vs 98% P < 0.001). Among current smokers, lung cancer pts were more agreeable (54%) to being assessed every visit compared to head and neck (aOR = 2.45 95% CI [0.9-6.5] P = 0.06) and non TRCs (aOR = 2.63 [1.0-6.8] P = 0.05). Among all, pts who are older (aOR = 1.03 [1.0-1.1]), curative (aOR = 1.92 [1.1-3.2]) and smoked less (aOR = 0.98 per pkyr [0.97-0.99]) were more agreeable to assessment at each visit. Conclusions: Most cancer pts felt that assessment of smoking status was important, were comfortable with being assessed and preferred being assessed directly by their oncologist. Routine screening of those currently smoking is recommended to help with cessation. Legal entity responsible for the study: Princess Margaret Cancer Centre Funding: None Disclosure: All authors have declared no conflicts of interest.
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