Abstract B17: Impact of behavior modification for tobacco usage in patients with a diagnosis of high-risk oral lesion

Abstract

Abstract Background: With tobacco and alcohol risk behaviors contributing to about three-quarters of cases, oral cancer is recognized as a preventable disease. Continuous smoking after treatment for high-risk oral lesions (HRLs) is associated with recurrence risk. However, there is little known about the impact of smoking behavioral changes in patients diagnosed with HRLs or their barriers for tobacco cessation. Objectives: 1) To collect pilot data regarding tobacco-related behavioral changes prior to and after the diagnosis of an HRL, and 2) To identify possible facilitators and barriers in tobacco cessation. Methods: A survey-type questionnaire is being developed for collecting data on smoking behaviors and cessation barriers. To avoid recall bias, patients with ever-smoking histories within 5 years of the diagnosis of an HRL are invited to participate in the study. A pilot cohort (N=25) has been interviewed to develop a refined questionnaire for a larger scale study. Results: Initial results show that all patients interviewed have a general understanding of the associations between tobacco consumption and its consequences on health. Of 25 patients recruited, there were 16 (64%) males and the average age is 55 ± 6.3 years. Ten (40%) have successfully quit after the diagnosis of an HRL and 6 (24%) expressed the intention to quit; while 6 (24%) have not made a decision regarding tobacco cessation and surprisingly, 3 (12%) have no intention of ceasing their tobacco habits even with a diagnosis of an HRL. All but 2 patients have experienced difficulty in tobacco cessation and 16 (64%) of them experienced smoking recurrence after their attempts to quit. The identified cessation barriers are mainly stress (‘smoking is a way to relax’, 64%) and smoking enjoyment (56%). The HRL diagnosis is the strongest message for the patients who quit successfully. Conclusion: Incorporation of an open-ended interview questionnaire allows for better understanding of smoking behaviors and complex cessation barriers in patients with HRLs. The barriers to tobacco cessation appear to be more psychosocial in nature, i.e., stress and smoking enjoyment. There is a need to develop effective intervention strategies targeting these individuals to improve tobacco cessation success, and consequently, reduce the risk of HRL recurrence. (Supported by research grants from the Canadian Institutes of Health Research (CIHR), Michael Smith Foundation for Health Research, and BC Cancer Foundation. DMT is supported by the Frederick Banting and Charles Best Canada Graduate Scholarships administered by CIHR.) Citation Information: Cancer Prev Res 2010;3(1 Suppl):B17.