It's a sad but familiar scene near the grounds of many medical campuses: hospital-gowned patients, some toting rolling IV poles, huddled in clumps under bus shelters or warming areas, smoking cigarettes.
Smoking causes 30 percent of all cancer deaths and 87 percent of all lung cancer deaths. Yet, roughly 50 percent to 83 percent of cancer patients keep smoking after a cancer diagnosis, through treatment and beyond, says Sonia Duffy, University of Michigan School of Nursing researcher. For patients who quit on their own, relapse rates (as in the general population) are as high as 85 percent.
Yet, continued smoking severely hampers cancer treatment, increases cancer recurrence and decreases survival, she says.
While it's easy to dismiss smoking as a lack of discipline or a disregard for one's own health, it's a much more complicated picture for these patients, says Duffy, lead researcher on the review paper, "Why Do Cancer Patients Smoke and What Can Providers Do About It," which appears in the journal Community Oncology.
"Ours is the first comprehensive review study to examine reasons why the very cause of the cancer, namely smoking, in many cases isn't treated," said Duffy, who said she wasn't prepared to find so many hurdles hindering smoking cessation in cancer patients.
"I think what surprised me when I did the review was the multitude of issues that cancer patients face, and that there are so many variables affecting why they don't get treatment, and if they do get treatment, why they may not respond. Nicotine addiction, health issues, emotional issues, psychological issues and system level issues are all in the way."