Prevalence of current cigarette smoking and relationships with demographic and psychosocial factors among patients with breast cancer in a nationwide study.

Abstract

e22550 Background: The purpose of this study was to assess the prevalence of current cigarette smoking among pre-treatment breast cancer patients and to explore the associations of smoking status with sociodemographic and psychosocial factors. Methods: This is a secondary data analysis of the pre-chemotherapy data of a nationwide longitudinal study designed to examine the impact of chemotherapy on cognitive function among breast cancer patients conducted via the University of Rochester Cancer Center NCI Community Oncology Research Program (URCC NCORP) Research Base. As part of this prospective cohort study, female breast cancer patients (stage I-IIIC) were recruited from 19 NCORP community sites. Participants (N = 433) were included if they responded two standard survey questions: 1) “Have you ever smoked 100 cigarettes or more in your lifetime?” and 2) “Are you currently smoking?”. Responses classified participants as currently smoking, formerly smoked, or never smoked. The baseline survey also collected data on sociodemographic characteristics, fatigue (Multidimensional Fatigue Symptom Inventory), cognitive reserve (proxied by the Wide Range Achievement Test), and anxiety symptoms (Spielberger State Trait Anxiety Inventory). Multinomial logistic regression assessed the likelihood of smoking status at baseline adjusted for significant covariates. The never smoked group served as the reference category. Results: Forty-eight participants were currently smoking (11%), 131 had formerly smoked (30%) and 254 had never smoked (59%). Divorced, separated or widowed participants were 4 times significantly more likely to currently smoke (RR [95% CI] = 4.05: 1.78-9.19) and twice as likely to formerly smoke (RR [95% CI] = 1.99[1.11-3.54]), relative to participants in long-term relationships. Single participants were 5 times significantly more likely to currently smoke (RR [95% CI] = 5.39 [1.81-15.99]). Participants with a college education or more were significantly less likely to currently smoke (RR [95% CI] = 0.21[0.13-0.62]), relative to those with lower education levels. Non-white participants were also significantly less likely to formerly smoke (RR [95% CI] = 0.41[0.18-0.93]), relative to white participants. Lastly, participants with higher cognitive reserve were less likely to currently (RR [95% CI] = 0.95 [0.88-1.00]) and formerly smoke (RR [95% CI]: 0.96 [0.92-1.01]), with only a marginally significant association (p = 0.06 and p = 0.08, respectively). Conclusions: Among pre-treatment breast cancer patients, the prevalence of current smoking was 11%. These findings highlight opportunities for tailored smoking cessation interventions and the importance of integrating smoking cessation programs into oncology care, particularly targeting sociodemographic disparities.