Gender disparity on cigarette smoking among cancer survivors: Results from the National Health Interview Survey.

Abstract

e24040 Background: The smoking rate has been declining in the United States. Smoking cessation is a critical part of cancer survivorship care. Males have higher smoking rate than females in the general population. However, it remains unclear if cancer status modified the effect of gender on smoking rates. Methods: To evaluate the long-term pattern of smoking prevalence among female cancer survivors, we used the National Health Interview Survey 2000-2017 to estimate the age-adjusted current smoking rates among cancer survivors and participants without a history of cancer for men and women separately. Multivariable linear regression was used to estimate age-adjusted smoking rate in each group, using the US 2010 Census as the standardization population. We also used multivariable logistic regression to examine the whether cancer history modified the influence of gender on current smoking rate. All statistical analyses were performed with SAS 9.4 and accounted for NHIS survey design. Results: Of 526,547 participants, we identified 32,091 cancer survivors, including 11,642 male and 20,449 female cancer survivors. Male cancer survivors had a slightly lower smoking rates than non-cancer male participants (cancer survivors: 16.2%-29.7% vs non-cancer participants: 16.8%-24.4%; OR = 0.94, 95%CI 0.88-1.00, p = 0.05) after adjusting age and year of survey. However, female cancer survivors had a significant higher prevalence of smoking compared with non-cancer female participants (cancer survivors: 20.1-32.6% vs non-cancer participants: women: 12.8%-20.4%; OR = 1.45, 95%CI 1.38-1.52, p < 0.001) during the same period. The gaps in smoking prevalence between female cancer survivors and male cancer survivors were more significant than the gaps between male non-cancer participants and female non-cancer participants from 2000 to 2017 (p interaction < 0.001). Conclusions: Although more men smoke among people without a history of cancer, female survivors had a higher age-adjusted smoking rate than their male counterparts. Effective smoking cessation interventions need to target female survivors as well as male survivors. A gender-sensitive approach is required to address their specific needs in smoking cessation. [Table: see text]