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Is a cancer diagnosis a teachable moment for the patient’s relative who smokes?

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Abstract

Purpose

This study examined a cancer diagnosis, versus orthopedic surgery, as a teachable moment for recruiting smokers and treating nicotine dependence among patients’ relatives.

Methods

Cancer patients and, for comparison, orthopedic patients at the University of Pennsylvania Health System were approached for referrals of relatives for a smoking cessation program, which involved behavioral counseling and nicotine patches. Primary outcomes were rate of program enrollment and rate of smoking abstinence. Potential mediators of smoking cessation were explored (e.g., treatment adherence, depression, anxiety). Two hundred and thirty-four relatives (113 cancer, 121 orthopedic) were considered eligible for the cessation program and comprised the study sample.

Results

Relatives of oncology patients were significantly more likely to enroll in the smoking cessation program, vs. orthopedic relatives (75 % vs. 60 %; OR = 1.96, 95 % CI 1.07–3.61, p = .03), but they were not significantly more likely to remain in the program (61 % vs. 52 %) or quit smoking (19 % vs. 26 %; p’s > .05). Compared to orthopedic relatives, oncology relatives showed significantly lower nicotine patch adherence and significantly greater levels of negative affect and depression and anxiety symptoms during treatment (p’s < .05). Further, orthopedic relatives, compared to oncology relatives, showed a greater reduction in the perceived benefits of smoking (p = .06), which was significantly associated with abstinence (p = .02).

Conclusions

While a family member’s cancer diagnosis may serve as a teachable moment for a smoker to enroll in a smoking cessation treatment program, high levels of psychological distress and perceptions of the benefits of smoking and low levels of treatment adherence may undermine successful abstinence among this population.

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Acknowledgments

This research was supported by grant CA126969 from National Cancer Institute. The authors thank Dr. Caryn Lerman for assistance with the trial and manuscript. The authors also thank Elisa Martinez, Paul D’Avanzo, Krystle Jackson, and Lynne Kohler who helped with the trial.

Conflict of interest

Dr. Schnoll has served as a consultant to GlaxoSmithKline, which manufactures the nicotine patch. However, GSK did not provide medication or financial support for this study. Dr. Schnoll also receives medication and placebo from Pfizer for other clinical trials, but Pfizer was not involved in the present study.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA

    Robert A. Schnoll & E. Paul Wileyto

  2. Pulmonary, Allergy, and Critical Care, University of Pennsylvania, Philadelphia, PA, USA

    Frank T. Leone

  3. Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA

    Corey Langer & Tracey Evans

  4. Orthopedic Oncology Center, Cooper University Medical Center, Camden, NJ, USA

    Richard Lackman

Authors
  1. Robert A. Schnoll
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  2. E. Paul Wileyto
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  3. Frank T. Leone
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  4. Corey Langer
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  5. Richard Lackman
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  6. Tracey Evans
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Corresponding author

Correspondence to Robert A. Schnoll.

Additional information

Clinicaltrials.gov: NCT00956943.

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Schnoll, R.A., Wileyto, E.P., Leone, F.T. et al. Is a cancer diagnosis a teachable moment for the patient’s relative who smokes?. Cancer Causes Control 24, 1339–1346 (2013). https://doi.org/10.1007/s10552-013-0212-2

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  • DOI: https://doi.org/10.1007/s10552-013-0212-2

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