David Buchbinder1, Kevin Oeffinger2, Conrado Franco-Villalobos3, Yutaka Yasui3, Melissa A Alderfer4,5, Gregory T Armstrong6, Jacqueline Casillas7, Jennifer Ford2, Kevin R Krull6, Wendy Leisenring8, Christopher Recklitis9, Leslie L Robison6, Lonnie K Zeltzer7, E Anne Lown10. 1. Division of Hematology, Department of Pediatrics, Children's Hospital of Orange County, Orange, California. 2. Memorial Sloan-Kettering Cancer Center, New York, New York. 3. Department of Biostatistics, School of Public and Health, University of Alberta, Alberta, Canada. 4. Center for Healthcare Delivery Science, Nemours Children's Health System, Wilmington, Delaware. 5. Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania. 6. Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee. 7. David Geffen School of Medicine at University of California at Los Angeles (UCLA) and UCLA Jonsson Comprehensive Cancer Center, Los Angeles, California. 8. Cancer Prevention Program at Fred Hutchinson Cancer Research Center, Seattle, Washington. 9. Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts. 10. Department of Social and Behavioral Sciences, University of California at San Francisco, San Francisco, California.
Abstract
BACKGROUND: Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. PROCEDURES: A retrospective cohort study was conducted using adult siblings (N = 1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N = 24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. RESULTS: Siblings were equally likely to have ever smoked compared to their peers (odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.12). Siblings were less likely to be current smokers (OR 0.83, 95%CI 0.73-0.94), but more likely to be former smokers (OR 1.21, 95%CI 1.08-1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95%CI 1.15-2.00) and be current smokers (OR 1.67, 95%CI 1.24-2.26) compared to their peers. Among siblings, risk factors for current tobacco use included the following: low income <$20,000 (OR 1.66, 95%CI 1.09-2.54), low education (OR 6.68, 95%CI 4.07-10.97), psychological distress (OR 5.36, 95%CI 2.21-13.02), and heavy alcohol use (OR 3.68, 95%CI 2.50-5.41). CONCLUSIONS: Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socioeconomic status families facing childhood cancer.
BACKGROUND: Having a brother or sister with childhood cancer may influence health behaviors during adulthood. The aim of this study was to compare tobacco use in siblings of survivors with peers and to identify factors associated with sibling tobacco use. PROCEDURES: A retrospective cohort study was conducted using adult siblings (N = 1,974) of 5+ year cancer survivors in the Childhood Cancer Survivor Study (CCSS) and participants (N = 24,105, weighted to match CCSS) in the 2007 National Health Interview Survey. Self-reported tobacco use, sociodemographic, and cancer-related risk factors were analyzed. RESULTS: Siblings were equally likely to have ever smoked compared to their peers (odds ratio [OR] 1.02, 95% confidence interval [CI] 0.93-1.12). Siblings were less likely to be current smokers (OR 0.83, 95%CI 0.73-0.94), but more likely to be former smokers (OR 1.21, 95%CI 1.08-1.35). Siblings with low education were more likely to ever smoke (OR 1.51, 95%CI 1.15-2.00) and be current smokers (OR 1.67, 95%CI 1.24-2.26) compared to their peers. Among siblings, risk factors for current tobacco use included the following: low income <$20,000 (OR 1.66, 95%CI 1.09-2.54), low education (OR 6.68, 95%CI 4.07-10.97), psychological distress (OR 5.36, 95%CI 2.21-13.02), and heavy alcohol use (OR 3.68, 95%CI 2.50-5.41). CONCLUSIONS: Siblings of survivors take up smoking at similar rates to their peers, but are more likely to quit. Efforts are needed to address disparities by providing greater psychosocial support and education for the lowest socioeconomic status families facing childhood cancer.
Authors: Alan C Geller; Karen Emmons; Daniel R Brooks; Zi Zhang; Catherine Powers; Howard K Koh; Arthur J Sober; Donald R Miller; Frederick Li; Frank Haluska; Barbara A Gilchrest Journal: J Am Acad Dermatol Date: 2003-10 Impact factor: 11.527