ASPO Abstracts
Continued smoking in African American cancer survivors: The Detroit Research on Cancer Survivors (ROCs) Cohort
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose: The Detroit Research on Cancer Survivors (ROCS) study is the largest population-based cohort of
African American cancer survivors collecting biospecimens, medical records, and survey data from breast,
prostate, lung and colorectal cancer cases. These data were used to identify factors associated with continued
smoking after a cancer diagnosis.
Methods: Participants who completed their baseline survey within 18 months of cancer diagnosis were used to
assess demographic and clinical variables associated with smoking status at cancer diagnosis and baseline
survey. Among those who reported smoking at the time of their cancer diagnosis, logistic regression was used to
estimate the odds of being a current smoker at baseline.
Results: Of 1145 cases analyzed, 497 (43%) reported never smoking, 446 (39%) were former smokers, and 202
(18%) were current smokers at baseline. At time of diagnosis, 356 cases reported smoking, of which 154 (43%)
had quit smoking at baseline survey and 202 (57%) remained current smokers. Factors associated with a reduced
odds of continued smoking included education (some college or more; [OR=0.21 95% CI (0.06, 0.69)]), and
increased social well-being (one of four components of the Functional Assessment of Cancer Therapy, an
assessment of quality of life in cancer patients) [OR=0.94 (0.90, .99)]. Factors associated with an increased odds
of continued smoking included alcohol use [OR=2.17 (1.16, 4.05)], AJCC stage III or IV diagnosis [OR=2.19 (1.08,
4.44)], living with a smoker [OR=3.99 (2.09, 7.62)], and higher cumulative years of smoking [OR=1.04 (1.01,
1.06)]. Lung cancer cases were most likely to quit after a diagnosis (n=69, 48.6%). Compared to lung cancer, all
other cancer sites had elevated odds of continued smoking, with highest odds among prostate cancer patients
[OR=6.76 (2.97, 15.39)].
Conclusions: Among African American cancer survivors, a breast, prostate or colorectal cancer diagnosis, late
stage diagnosis, years of smoking, and living with a smoker increased the likelihood of continued smoking after
diagnosis. These findings reveal that cessation strategies need to be incorporated into treatment plans, especially
for prostate cancer survivors, and such strategies should be extended to all smokers in the household.
Keywords: tobacco cessation, survivor, African American