Health behavior theory constructs and smoking and cessation-related behavior among survivors of ten cancers nine years after diagnosis: A report from the American Cancer Society's Study of Cancer Survivors-I.

OBJECTIVE: Quitting smoking is important for cancer prognosis, but some cancer survivors continue to smoke. This study examined psychological correlates of smoking status and patterns, likelihood of quitting, and intentions to quit among long-term survivors.
METHODS: Cross-sectional relationships between psychological constructs from health behavior theories (e.g., perceived risk, quitting barriers) and smoking and cessation-related behavior were examined among survivors of 10 cancers. Survivors were recruited by stratified random sampling from cancer registries in a nationwide, longitudinal, quality-of-life study (n=2938).
RESULTS: Approximately 9 years post-diagnosis, survivors who currently smoke (compared with those who quit before or after diagnosis) perceived health problems caused by smoking as less severe, perceived fewer benefits of quitting for cancer survivors, greater barriers to quitting, and reported more daily exposure to others' smoking. Survivors intending to quit (vs. those not intending or unsure) perceived greater risks of smoking for cancer prognosis, more severe health effects from smoking, fewer benefits of smoking, and greater social pressure to quit. Nondaily smokers had higher levels of self-efficacy and less exposure to others' smoking compared to daily smokers.
CONCLUSIONS: Long-term cancer survivors' perceptions of the risks of smoking for cancer prognosis, the severity of health problems from smoking, cessation barriers, and the benefits of quitting are appropriate targets for interventions for continuing smokers. Nondaily smokers may be especially amenable to intervention. Survivors' daily exposure to others' smoking should also be addressed in treatment.