Abstract

Smoking among cancer patients leads to poorer outcomes, yet many patients continue smoking. As part of a feasibility study of smoking cessation for cancer patients in Ireland, smoking rates were reviewed. Hospital Inpatient Enquiry (HIPE) data on the smoking status of discharges with a cancer diagnosis (overall, breast, lung, cervical and head and neck cancer) were used (2014–2018). During 2014–2017, current smoking increased for overall (10.5–11.7%) and lung cancer (24.7–27.2%), then decreased to 11.4% and 24.1%, respectively, in 2018. Current smoking increased for cervical during 2014–2018 (11–19.8%) and initially (2014–2016) for head and neck (3–12.7%) cancer, decreasing to 7.6% in 2018; breast cancer was stable at 6 ± 0.6%. These rates are lower than the Irish (23–20%) and European (29% (average)) general population. During 2014–2017, past smoking increased among overall (15.2–21%) and specific cancers, which was lower than the Irish general population (23–28%). Current smoking was highest among 50–59-year-olds (14–16%), which contrasts with the Irish general population (24–35 years at 32–28%). HIPE data are subject to potential duplicate episodes of care and under-documentation of smoking. However, trend analysis is useful, as these limitations should be stable. Rates remain high; therefore, robust documentation and smoking cessation referrals for cancer patients are important.

Highlights

  • Tobacco smoking has been causally linked as an independent risk factor in the pathogenesis and development of a wide variety of cancers [1]

  • Tobacco smoking is associated with an increased risk of recurrence [3–5], the development of second primary cancers [3,6–8], poorer treatment outcomes [3,4,9], lower survival rates and decreased quality of life [3,10], and pulmonary, cardiovascular and wound complications leading to increased length of hospital stay [11,12]

  • Mortality among lung cancer patients is higher with increased smoking and home/work second-hand smoke exposure [13]

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Summary

Introduction

Tobacco smoking has been causally linked as an independent risk factor in the pathogenesis and development of a wide variety of cancers [1]. Tobacco smoking is associated with an increased risk of recurrence [3–5], the development of second primary cancers [3,6–8], poorer treatment outcomes (including treatment-related complications and toxicities) [3,4,9], lower survival rates and decreased quality of life [3,10], and pulmonary, cardiovascular and wound complications leading to increased length of hospital stay [11,12]. There is a growing body of evidence that smoking cessation improves outcomes following the diagnosis of several different cancers [8,14,15]. Some of these smoking-related complications are seen to decrease by 19% with each week of cessation [11].

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