ASPO Abstracts
Nicotine as a Risk Factor for Substance Abuse in Cancer Patients
Category: Early Detection & Risk Prediction
Conference Year: 2023
Abstract Body:
Background: Compared to cancer patients without tobacco/nicotine disorder (TND), those with TND may be at heightened risk for other conditions warranting intervention. Characterization of these comorbidities has not been assessed based on patient records. Methods: Data were obtained from a database of electronic health records for patients from the University of California health system. The odds for every condition among cancer patients with TND were compared with those for cancer patients without TND. Stratified analysis was conducted for each of the twenty most common cancers observed. ORs were adjusted for gender, ethnicity, and race. Results: 3,791 cancer patients with TND had 252,619 total conditions, and 51,711 cancer patients without TND had 2,310,880 conditions. After adjusting for confounders, the condition for which TND most exacerbated risk was psychoactive substance-induced organic anxiety disorder (OR=16.3, p<0.001). This appeared consistent with the second, third, and fifth most-exacerbated conditions: stimulant abuse (OR=12.8, p<0.001), cocaine induced mental disorder (OR=11.0, p<0.001), and cocaine abuse (OR=11.0, p<0.001). Different conditions exacerbated by TND include acute alcoholic intoxication (OR=11.4, p<0.001), opioid abuse (OR=7.6, p<0.001), schizoaffective disorder (OR=7.4, p<0.001), and cannabis abuse (OR=6.3, p<0.001). TND increased risk for psychoactive substance-induced organic anxiety disorder specifically among patients with colorectal cancer (OR=3.1, p=0.032) and patients experiencing neoplasm-related pain (OR=3.4, p=0.019) in adjusted models. Conclusions: Cancer patients with nicotine dependence are at heightened risk for substance abuse and related mental health conditions. An update of clinical guidelines for screening and other interventional services for cancer patients presenting with nicotine dependence should be considered.
Keywords: cancer, nicotine, substance abuse, comorbidities