141st APHA Annual Meeting and Exposition

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281094
Smoking prevalence among childhood cancer survivors by region: A call for action


Tuesday, November 5, 2013

Taghrid Asfar, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Stacey L. Tannenbaum, PhD, RD, LD/N, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Laura A. McClure, MSPH, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL
Tainya Clarke, MPH, MS, Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine, Miami, FL
Jenelle Lin, BS, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL
Lora E. Fleming, MD, PhD, Department of Epidemiology & Public Health, University of Miami, Miller School of Medicine, Miami, FL
David J. Lee, PhD, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Background: The cure rate for pediatric cancers exceeds 75% and the number of childhood cancer survivors (CCSs) is steadily increasing in the US. CCSs are at increased risk for recurrence, second primary cancers, late effects of treatment, and a variety of health issues that can be exacerbated by smoking. Mapping smoking prevalence among survivors in the US can help guide prevention and cessation efforts among CCSs.

Methods: Using pooled data from the 1997-2010 National Health Interview Survey, we compared the smoking prevalence among CCSs (defined as those who were diagnosed with cancer before the age 21 years) (n=1,673; representing 913,702 people) with individuals with no history of cancer (n= 383,805; representing 197,374,225 people) by sex and region of residence (Northeast, Midwest, South, and West).

Results: Overall, 34.3% of CCSs were smokers compared to 21.8% of those with no cancer. The highest prevalence of smoking was in the Southern US region for CCSs (37.5%; 95% CI 32.9-42.3); and in the Midwest for the general population (24.5%; 24.0-25.0). Smoking prevalence among female survivors was double those without cancer history (38.7%; 35.01-42.48, and 19.2%; 18.90-19.43), respectively; while it was similar among males (26.2%; 21.39-31.56, and 24.7%; 24.35-24.98), respectively.

Conclusion: Smoking prevalence in CCSs is higher than the general population in the US, especially among women, and varies markedly by region. Targeting CCSs, especially females, with effective smoking cessation and prevention interventions is urgently needed.

Learning Areas:

Epidemiology
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the health consequences of smoking in childhood cancer survivors during treatment and beyond. Compare smoking prevalence of survivors with individuals without cancer history by region of residence in the US (Northeast, Midwest, South, and West) and by sex. Discuss possible reasons why regional and gender differences are present among childhood cancer survivors.

Keyword(s): Smoking, Cancer Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I’m a tobacco control researcher with long standing experience in conducting smoking cessation trials. I served as project director on multiple smoking cessation interventions in the US and abroad and published papers on the topic of fielding in smoking cessation interventions in diverse settings. I worked as a Project Director for NCI funded study, “Efficacy of a Tobacco Quit Line for Childhood Cancer Survivors” in the Department of Epidemiology at St. Jude Children’s Research Hospital.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4263.0: Novel Research on Tobacco Use Among Youth and Young Adults: Who? What? Why? When? Where?