Even cancer isn’t enough to get many smokers to quit, study finds

This cancer survivor smokes a cigarette on his boat in Newport Beach.
(Mark Boster / Los Angeles Times)

There’s nothing like a serious health scare to convince smokers to kick the habit, but new research finds that nearly 1 in 10 cancer survivors is still smoking nine years after their diagnosis.

The 9.3% smoking rate among American cancer survivors is about half as high as the 18.1% smoking rate among American adults as a whole, according to data from the Centers for Disease Control and Prevention.

Smoking doesn’t just increase the risk for certain types of cancers; it also makes cancer treatments less effective, makes cancers more likely to come back after treatment, and makes them come back faster.

Researchers from the American Cancer Society and Emory University, both in Atlanta, examined data from the ongoing Study of Cancer Survivors. This study tracks a random sample of adults from 11 states around the country who have been diagnosed with a common type of cancer. (The cancers included in the study are breast, prostate, bladder, uterine, melanoma, colorectal, kidney, non-Hodgkin lymphoma, ovarian and lung.)


Nearly 3,000 study participants were diagnosed between 2000 and 2003 and were still alive in 2010 and 2011 (on average, 8.9 years had passed since their cancer was diagnosed). They answered questions about their smoking behavior in those later years.

Overall, 272 of the 2,938 cancer survivors were still smoking, according to the survey data. Among these smokers, 83% smoked every day, and they smoked an average of 14.7 cigarettes daily. The other smokers smoked about once every three days, and on those days they burned through an average of 5.7 cigarettes.  

About half of the cancer survivors who were still smoking said they had no intention of quitting, the researchers found.

Another 137 of the cancer survivors reported that they were active smokers when they were diagnosed but had quit since then. That means that one-third of all of the people who were smokers when they were diagnosed were able to quit after nine years, the researchers reported. (Another 1,072 of the cancer survivors were former smokers who had already stopped smoking when they were diagnosed.)


Smokers who were diagnosed with a smoking-related cancer were 73% more likely to quit compared with smokers who had other types of cancer, the researchers calculated.

But this doesn’t necessarily mean that a diagnosis of lung cancer or another cancer linked to smoking served as a wake-up call to these smokers, the researchers wrote. Rather, the data may simply reflect the fact that fewer people with these types of cancers survived long enough to be interviewed in 2010 and 2011.

“Survivors who smoked daily smoked at relatively high levels and would likely have a difficult time quitting because of their tobacco dependence,” the researchers wrote.

In addition, older smokers were less likely to say they intended to quit, probably because they “feel that the effort or difficulties in quitting (e.g. withdrawal symptoms) may not be worth the possible gain in greater life expectancy,” the researchers wrote.

Among all of the cancer survivors, the smoking rate was highest among those who had bladder cancer (17.2%), followed by lung cancer (14.9%) and ovarian cancer (11.6%). Survivors who were women, were younger, had less education and had lower incomes were all more likely to smoke compared with survivors as a whole.

The lowest smoking rates were seen in adults who had been diagnosed with colorectal cancer (6.8%), kidney cancer (7.3%) and melanoma (7.6%), the researchers found.

The results were published this week in Cancer Epidemiology, Biomarkers & Prevention.

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