Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Upper Aerodigestive Tract Cancer

The Article in Brief

Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Aerodigestive Tract Cancer

Amanda Farley , and colleagues

Background Stopping smoking after being diagnosed with lung, bladder, and upper aerodigestive tract cancer appears to improve patients' survival. Support to quit smoking could strengthen these efforts. This study set out to assess how often general practitioners in the UK provide smoking cessation support in patients with lung, bladder, and upper aerodigestive tract cancer compared to patients with coronary heart disease and whether this effort is influenced by incentive payments.

What This Study Found Physicians are more likely to support smoking cessation in primary care patients with coronary heart disease than those with cancer, and patients with cancer are less likely to stop smoking. Using electronic records, 12,393 incident cases of lung, bladder and upper aerodigestive tract cancers diagnosed between 1999-2013 were matched 1:1 with incident coronary heart disease cases. At diagnosis, 32 percent of patients with cancer and 18 percent of patients with coronary heart disease smoked. People with cancer were less likely than controls to have smoking status recorded by their GP (37 percent versus 78 percent), be given advice to quit smoking (23 percent versus 45 percent), or be prescribed smoking cessation medication (12 percent versus 21 percent). Of the 3,706 cancer/heart disease patients who smoked at diagnosis and had at least one smoking status update in the year following diagnosis, 1,359 (37 percent) of patients with cancer and 1,645 (44 percent) of patients with heart disease stopped smoking. The frequency of recording of smoking status, advice and pharmacotherapy increased after introduction of incentive payments for GPs to manage smoking but there were no differences in the rates of quitting.

Implications

• The authors call for improvements in the management of smoking cessation by general practitioners for patients with cancer.