Prevalence and Correlates of Successful Smoking Cessation in Bladder Cancer Survivors

Abstract

To assess the prevalence and correlates of successful smoking cessation in bladder cancer survivors. A population-based sample of bladder cancer survivors diagnosed over a 3 year period was obtained from the California Cancer Registry. Respondents completed a survey about their tobacco use and attempts at smoking cessation. Contingency tables and logistic regression analyses were used to evaluate for correlates of successful smoking cessation. Of total survey respondents, 19% (151 of 790) were active smokers at bladder cancer diagnosis and made up our analytic cohort. The majority of included respondents were male, older than 60, and had smoked for >40 years prior to diagnosis. After diagnosis, 76% (115 of 151) of active smokers made a quit attempt and 56% (65 of 115) were successful. Success with smoking cessation was more frequent among those who attempted to quit around the time of initial bladder cancer diagnosis. The majority (66%) of successful quitters did so "cold turkey" without pharmacotherapy or behavioral therapy. After adjustment for demographic and tobacco-related factors, quit attempts specifically motivated by the bladder cancer diagnosis were highly associated with smoking cessation success (OR 11.6; 95% CI 3.73-35.8). Use of pharmacologic or behavioral therapies in the quit attempt were not significantly associated with successful smoking cessation. Our data underscore the importance of motivation, timing, and the role of the urologist in the quit attempts of bladder cancer survivors. Emphasis should be placed on ensuring the newly diagnosed make a timely quit attempt informed by the causal role of smoking in their malignancy.