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The Influence of Malignancy and Referring Department on Smoking Cessation Success
Conference Paper/Poster - Apr 28, 2010
Putora Paul Martin, Baty Florent, Ludwig Peter, Rogenmoser Gabriela, Plasswilm Ludwig, Brutsche Martin
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Background: Smoking cessation programs are often under-utilized. This is usually the case with patients with malignant disease including lung cancer. Possibly, some physicians deem cancer patients less fit for smoking cessation programs, perhaps due to life expectancy issues. Our aim was to analyse whether cancer patients did differently in smoking cessation programs.
Method: We retrospectively analysed 635 patients that had at least one smoking cessation consultation at the Kantonsspital St. Gallen between 2006 and 2009. Factors that were analysed included their diagnosis list, whether the patients had a malignancy and specifically whether patients had lung cancer. Another factor we included in the analysis was the referring department. Using logistic regression and Pearson’s Chi-squared test, we tested the influence of these factors on the success of the smoking cessation program.
Results: Of evaluable patients 8% (42/546 pts) had lung cancer and 12% (53/441 pts) had a other malignant disease. The 1-month quit rate was 54%, 55%, 44% for patients with non-malignant disorders, lung cancer and other malignancy respectively (Chi-square test: p 0.73). Malignancy as a parameter also had no effect on the success rate: 48% with and 54% without cancer (Chi-square test: p 0.72). Of the 441 patients, where a referring department could be identified, only 5% (21 pts) were referred from the oncology department. As expected, a difference could not be determined. There was no difference in the success rate between patients from medical and surgical departments. A factor that stood out was the motivational stage. In the Prochaska stage “active”, the success rates were much higher than in the low-motivated patients (OR: 12.3 [2.6 - 89.9]).
Conclusion: We could demonstrate that lung cancer patients do not do worse in a smoking cessation program than patients with other malignancies or non-malignant diseases. Also, the referring department had no effect on the smoking cessation success rate. Our conclusion is that the diagnosis of lung cancer is no reason to expect the patient doing worse in a smoking cessation program. Therefore we recommend all treating physicians in pneumooncology to consider smoking cessation programs for all of their patients.