Perceived Difficulty Quitting Predicts Enrollment in a Smoking-Cessation Program for Patients With Head and Neck Cancer

Autor: Karen E. Fowler, Angela L. Scheumann, Cynthia S. Darling-Fisher, Jeffrey E. Terrell, Sonia A. Duffy
Rok vydání: 2010
Předmět:
Zdroj: Oncology Nursing Forum. 37:349-356
ISSN: 1538-0688
0190-535X
DOI: 10.1188/10.onf.349-356
Popis: Smoking is the major causative agent of head and neck cancer (Freedman, Abnet, Leitzmann, Hollenbeck, & Schatzkin, 2007). Smoking after a diagnosis of head and neck cancer can severely decrease quality of life, increase recurrence, and decrease survival (Dikshit et al., 2005; Duffy et al., 2007). Yet 35%–46% of patients with head and neck cancer continue to smoke after diagnosis of cancer (Duffy et al., 2007), compared to approximately 21% of the general population (Centers for Disease Control and Prevention, 2007). The Health Promotion Model (HPM) (Srof & Velsor-Friedrich, 2006) has been used as a framework for predicting health-promoting lifestyles in a variety of populations, including patients with cancer (Frank-Stromborg, Pender, Walker, & Sechrist, 1990; Lusk, Ronis, Kerr, & Atwood, 1994). The HPM identifies key cognitive and perceptual variables which influence behavior change. A central component of the HPM that predicts behavior change, including smoking cessation, is self-efficacy (Friend & Pagano, 2007; Gritz et al., 1991). If a patient perceives that smoking cessation is a difficult task, his or her self-efficacy for that task would be low. Continuous smokers and those who decline cessation programs have been found to have a decreased level of risk perception associated with smoking along with lower motivation and self-efficacy for smoking cessation (Schnoll et al., 2003, 2004). An association exists between level of nicotine dependence and smoking cessation, with less heavily dependent smokers being more successful in quitting (Pinto, Abrams, Monti, & Jacobus, 1987) and less likely to participate in cessation programs (Audrain-McGovern, Halbert, Rodriguez, Epstein, & Tercyak, 2007). Many smokers with head and neck cancer also regularly consume alcohol. Smoking increases during alcohol consumption, and heavy drinkers are less likely to attempt to quit and less likely to be successful when they do (Marks, Hill, Pomerleau, Mudd, & Blow, 1997; Piasecki, McCarthy, Fiore, & Baker, 2008). People with depression are much more likely to use tobacco than nondepressed people (Epstein, Induni, & Wilson, 2009). Decreases in depression are associated with increases in smoking-cessation rates (Friend & Pagano, 2007). For some, a diagnosis of head and neck cancer may result in a “teachable moment,” a time when patients may be more likely to comply with smoking-cessation advice (Gritz et al., 2006). For others, a life-threatening disease may make quitting smoking a low priority because they believe that a cancer diagnosis means it is too late to quit (Sharp & Tishelman, 2005). Patients are more likely to continue smoking if they have an earlier stage of disease or have tumors in the oral cavity (Ostroff et al., 1995; Vander Ark, DiNardo, & Oliver, 1997), whereas patients with cancer of the larynx resulting in a total laryngectomy are more likely to quit smoking (Vander Ark et al., 1997). Patients with head and neck cancer often are perceived as difficult to reach and unlikely to adhere to behavior changes such as quitting smoking (Gritz et al., 1991). Older patients tend to be heavier smokers than young adults and, therefore, have more difficulty with smoking cessation (Messer, Trinidad, Al-Delaimy, & Pierce, 2008). Women are less likely to quit than men (Husten et al., 1997). Caucasians are more likely to participate in smoking-cessation programs (Audrain-McGovern et al., 2007; Husten et al., 1997), but African Americans have a greater sense of self-efficacy for quitting and more interest in cessation services than Caucasians (Daza et al., 2006; Duffy et al., 2002). Educational level is inversely related to smoking; those with a high school education or greater are more likely to participate in smoking cessation (Husten et al., 1997). The authors’ prior work in a randomized, controlled trial showed that patients with head and neck cancer can quit if offered cessation services (Duffy et al., 2006); however, many eligible smokers who consented to be screened did not participate in the study. Identification of the characteristics of nonparticipants may assist healthcare providers in developing outreach strategies to capture patients with head and neck cancer for future smoking-cessation interventions. Hence, the purpose of this study was to determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer.
Databáze: OpenAIRE
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