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Smoking Among Participants in the Childhood Cancer Survivors Cohort: The Partnership for Health Study

Karen M. Emmons, Rita M. Butterfield, Elaine Puleo, Elyse R. Park, Ann Mertens, Ellen R. Gritz, Maureen Lahti, Fredrick P. Li

From the Dana-Farber Cancer Institute/Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, MA; University of Massachusetts at Amherst, Amherst, MA; and University of Minnesota, Minneapolis, MN; The University of Texas, M.D. Anderson Cancer Center, Houston, TX.

Address reprint requests to Karen M. Emmons, PhD, Harvard School of Public Health and Dana-Farber Cancer Institute, Center for Community-Based Research, 44 Binney Street, Boston, MA 02115; email: Karen_Emmons{at}dfci.harvard.edu.

Purpose: This article describes baseline data collection and the intervention design of Partnership for Health, a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study. The purpose of this article is to evaluate demographic, psychosocial, and cancer-related factors that are associated with smoking behavior and mediators of smoking cessation.

Patients and Methods: This study includes 796 smokers from the Childhood Cancer Survivors Study database who were diagnosed with cancer before the age of 21, had survived at least 5 years, and were at least 18 years of age at the time of the baseline survey. Correlates of smoking behaviors included smoking rate, number of recent quit attempts, and nicotine dependence; two key mediators of smoking cessation, readiness to quit smoking and self-efficacy, were also assessed.

Results: Participants smoked, on average, 14 cigarettes/day; 53.2% were nicotine dependent, and 58% had made at least one quit attempt in the past year. Smoking behaviors were primarily associated with demographic variables; mediators of cessation were primarily associated with age at cancer diagnosis and perceived vulnerability to smoking-related illnesses. Severity of psychologic symptoms was associated with increased smoking rate, high nicotine dependence, and low self-efficacy. Support for quitting was related to smoking rate, number of quit attempts, readiness to quit smoking, and self-efficacy.

Conclusion: These findings indicate that many cancer survivors who smoke are receptive to smoking cessation interventions. Factors related to mediators of smoking cessation might be particularly good targets for intervention.

Supported by grants U24-CA55727 and RO1-CA77780 from the National Institutes of Health; support provided to the University of Minnesota by the Children’s Cancer Research Fund, and support to the Dana-Farber Cancer Institute by Liberty Mutual and the Harry and Elsa Jiler American Cancer Society Research Professorship (F. Li).

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