Abstract
BackgroundDespite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored. Little is known about how cancer patients experience smoking and alcohol interventions in relation to surgery. Therefore the aim of this study was to explore how bladder cancer patients experience a perioperative smoking and alcohol cessation intervention in relation to radical cystectomy.MethodsA qualitative study was conducted in two urology out-patient clinics. We conducted semi-structured in-depth interviews with 11 purposively sampled persons who had received the smoking and alcohol cessation intervention. The analysis followed the steps contained in the thematic network analysis.ResultsTwo global themes emerged: “smoking and alcohol cessation was experienced as an integral part of bladder cancer surgery” and “returning to everyday life was a barrier for continued smoking cessation/alcohol reduction”. Participants described that during hospitalization their focus shifted to the operation and they did not experience craving to smoke or drink alcohol. Concurrent with improved well-being or experiencing stressful situations, the risk of relapse increased when returning to everyday life.ConclusionsThe smoking and alcohol cessation intervention was well received by the participants. Cancer surgery served as a kind of refuge and was a useful cue for motivating patients to quit smoking and to reconsider the consequences of risky drinking. These results adds to the sparse evidence of what supports smoking and alcohol cessation in relation to bladder cancer patients undergoing major surgery and point to the need to educate healthcare professionals in offering smoking and alcohol cessation interventions in hospitals. The study also provides knowledge about the intervention in the STOP-OP study and will help guide the design of future smoking and alcohol cessation studies aimed at cancer patients undergoing surgery.
Highlights
Despite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored
The study formed part of the STOP-OP study (Stop smoking and alcohol drinking before operation for bladder cancer), a randomized controlled trial evaluating the effect on postoperative complications and quit rates of an intensive smoking and alcohol cessation intervention in relation to radical cystectomy [33]
A global theme emerged to explain the participants’ experience of participating in a smoking and alcohol cessation intervention in relation to radical cystectomy. We present this as Smoking and alcohol cessation was experienced as an integral part of bladder cancer surgery
Summary
Despite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored. The aim of this study was to explore how bladder cancer patients experience a perioperative smoking and alcohol cessation intervention in relation to radical cystectomy. Radical cystectomy is a highly morbid procedure and complication rates vary from 30 to 64% [1, 2] regardless of operative technique [3] Both smoking and risky alcohol drinking are modifiable risk factors for cancer as well as postoperative complications [4,5,6]. A commonly described barrier that may prevent health professionals from offering patients smoking cessation interventions is that addressing smoking will be unwanted by the patient or might imply judgement from the healthcare professionals [26, 27] It is well-known that cancer survivors are interested in lifestyle-interventions [28], but still little is known about how cancer patients experience these interventions [29, 30]. The aim of this study was to explore how bladder cancer patients experienced a perioperative smoking and alcohol cessation intervention in relation to radical cystectomy
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