Cigarette and alternative tobacco product use among adult cancer survivors enrolled in 9 ECOG-ACRIN clinical trials Journal Article


Authors: Streck, J. M.; Lee, J. W.; Walter, A. W.; Rosen, R. L.; Gareen, I. F.; Kircher, S. M.; Herman, B. A.; Carlos, R. C.; Kumar, S.; Mayer, I. A.; Saba, N. F.; Fenske, T. S.; Neal, J. W.; Atkins, M. B.; Hodi, F. S.; Kyriakopoulos, C. E.; Tempany, C.; Shanafelt, T. D.; Wagner, L. I.; Land, S. R.; Park, E. R.; Ostroff, J. S.
Article Title: Cigarette and alternative tobacco product use among adult cancer survivors enrolled in 9 ECOG-ACRIN clinical trials
Abstract: Background: While cigarette smoking has declined among the U.S. general population, sale and use of non-cigarette alternative tobacco products (ATP; e.g., e-cigarettes, cigars) and dual use of cigarettes/ATPs are rising. Little is known about ATP use patterns in cancer survivors enrolled in clinical trials. We investigated prevalence of tobacco product use, and factors associated with past 30-day use, among patients with cancer in national trials. Methods: Cancer survivors (N = 756) enrolled in 9 ECOG-ACRIN clinical trials (2017–2021) completed a modified Cancer Patient Tobacco Use Questionnaire (C-TUQ) which assessed baseline cigarette and ATP use since cancer diagnosis and in the past 30 days. Results: Patients were on average 59 years old, 70% male, and the mean time since cancer diagnosis was 26 months. Since diagnosis, cigarettes (21%) were the most common tobacco product used, followed by smokeless tobacco use (5%), cigars (4%), and e-cigarettes (2%). In the past 30 days, 12% of patients reported smoking cigarettes, 4% cigars, 4% using smokeless tobacco, and 2% e-cigarettes. Since cancer diagnosis, 5.5% of the sample reported multiple tobacco product use, and 3.0% reported multiple product use in the past 30 days. Males (vs. females; OR 4.33; P = 0 < 0.01) and individuals not living with another person who smokes (vs. living with; OR, 8.07; P = 0 < 0.01) were more likely to use ATPs only versus cigarettes only in the past 30 days. Conclusions: Among patients with cancer, cigarettes were the most prevalent tobacco product reported. Impact: Regardless, ATPs and multiple tobacco product use should be routinely assessed in cancer care settings. © 2023 American Association for Cancer Research.
Keywords: adult; middle aged; united states; neoplasm; neoplasms; cancer survivor; azathioprine; adenosine triphosphate; tobacco; cancer survivors; tobacco use; smokeless tobacco; tobacco, smokeless; humans; human; male; female; tobacco products; electronic nicotine delivery systems
Journal Title: Cancer Epidemiology Biomarkers and Prevention
Volume: 32
Issue: 11
ISSN: 1055-9965
Publisher: American Association for Cancer Research  
Date Published: 2023-11-01
Start Page: 1552
End Page: 1557
Language: English
DOI: 10.1158/1055-9965.Epi-23-0420
PUBMED: 37410096
PROVIDER: scopus
PMCID: PMC10773003
DOI/URL:
Notes: Article -- Source: Scopus
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  1. Jamie S Ostroff
    344 Ostroff