To identify the stability of smoking status after diagnosis including quit attempts and quit intentions.
Participants were recruited via the cancer registries in NSW and Victoria as part of the longitudinal Cancer Survival Study (CSS). Surveys were mailed at T1 (6 months post diagnosis), T2 (1 year post diagnosis), T3 (2 years post diagnosis) and T4 (3.5 years post diagnosis). Participants were 18-80 years old and diagnosed with a first primary cancer (prostate, colorectal, female breast, lung, melanoma, non-Hodgkin’s lymphoma, leukaemia and head and neck). Smoking status and quitting behaviours were assessed at each study time point.
A cohort of 1453 people was recruited. Sixty-six (35.5%) of the 186 self-reported smokers at diagnosis had quit in the 6 months post-diagnosis and 120 (64.5%) reported being a current smoker at T1. Of the smokers at T1 40.1% intended to quit: with 7.5% having quit smoking by T2; 10% quit by T3; and 10.8% quit by T4. Of the 49 who reported at T1 that they intended to quit in the next 6 months, 10.2% or fewer reported having quit at any subsequent study time point. Quitting attempts appeared to decrease in frequency over time post diagnosis. A small proportion of non-smokers or former smokers (<1%) took up smoking at each study time point. Less than 10% of respondents who had quit at or shortly before diagnosis reported relapse to smoking at each follow-up.
While a diagnosis of cancer may prompt a quit attempt, the majority of smokers continue to smoke beyond diagnosis. Continued smoking occurs despite a substantial minority having a stated intention to quit and making attempts to do so. There is a need to identify and implement effective cessation strategies for people who smoke and who have had a diagnosis of cancer.