Smokeless and dual tobacco use among males surviving childhood cancer

A report from the childhood cancer survivor study

James L. Klosky, Ashley M. Hum, Nan Zhang, Khatidja S. Ali, D. Kumar Srivastava, Robert Klesges, Karen M. Emmons, Kirsten K. Ness, Marilyn Stovall, Leslie L. Robison, Melissa M. Hudson

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Cancer survivors experience treatment-related complications that can be exacerbated by tobacco use. This study reports the prevalence of smokeless and dual tobacco use, compares these rates to the U.S. population, and examines tobacco risk factors among males surviving childhood cancer. Data from the Childhood Cancer Survivor Study (CCSS) 2007 survey were used (N = 3378). Standardized incidence ratios (SIR) were obtained by comparing CCSS data with the National Survey on Drug Use and Health. Logistic regression was used to evaluate associations between risk factors and tobacco use. Amongmale survivors, 8.3% and 2.3% were current smokeless tobacco and dual tobacco users, respectively. Survivors were less likely than population males to report smokeless tobacco [SIR = 0.64; 95% confidence interval (CI), 0.57-0.72) or dual tobacco (SIR = 0.37; CI, 0.29-0.46) use; however, non-White survivors aged 35 to 49 years were more likely to use smokeless tobacco (SIR = 2.32; CI, 1.27-3.90). Smokeless tobacco use was associated (P < 0.05) with younger age at diagnosis, lower education, being married or divorced/separated, and not living in the Northeastern United State, whereas history of cardiovascular- and/or pulmonary-toxic treatment was protective. Dual tobacco use was associated with younger age at diagnosis, lower education, divorce/separation, and high psychologic distress. Having active heart or circulatory conditions was protective. Although smokeless tobacco/dual tobacco use is generally low among childhood cancer survivors, these findings suggest that tobacco use screening should be expanded to include smokeless tobacco use, and that smokeless tobacco-specific education and cessation interventions should be provided to users. Screening and intervening for smokeless tobacco/dual tobacco use in childhood cancer survivors will reduce tobacco-related morbidity and mortality.

Original languageEnglish (US)
Pages (from-to)1025-1029
Number of pages5
JournalCancer Epidemiology Biomarkers and Prevention
Volume22
Issue number6
DOIs
StatePublished - Jun 1 2013

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Smokeless Tobacco
Tobacco Use
Survivors
Neoplasms
Tobacco
Divorce
Incidence
Confidence Intervals
Education
New England
Poisons
Population
Cross-Sectional Studies
Logistic Models
Morbidity
Lung

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

Smokeless and dual tobacco use among males surviving childhood cancer : A report from the childhood cancer survivor study. / Klosky, James L.; Hum, Ashley M.; Zhang, Nan; Ali, Khatidja S.; Srivastava, D. Kumar; Klesges, Robert; Emmons, Karen M.; Ness, Kirsten K.; Stovall, Marilyn; Robison, Leslie L.; Hudson, Melissa M.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 22, No. 6, 01.06.2013, p. 1025-1029.

Research output: Contribution to journalArticle

Klosky, JL, Hum, AM, Zhang, N, Ali, KS, Srivastava, DK, Klesges, R, Emmons, KM, Ness, KK, Stovall, M, Robison, LL & Hudson, MM 2013, 'Smokeless and dual tobacco use among males surviving childhood cancer: A report from the childhood cancer survivor study', Cancer Epidemiology Biomarkers and Prevention, vol. 22, no. 6, pp. 1025-1029. https://doi.org/10.1158/1055-9965.EPI-12-1302
Klosky, James L. ; Hum, Ashley M. ; Zhang, Nan ; Ali, Khatidja S. ; Srivastava, D. Kumar ; Klesges, Robert ; Emmons, Karen M. ; Ness, Kirsten K. ; Stovall, Marilyn ; Robison, Leslie L. ; Hudson, Melissa M. / Smokeless and dual tobacco use among males surviving childhood cancer : A report from the childhood cancer survivor study. In: Cancer Epidemiology Biomarkers and Prevention. 2013 ; Vol. 22, No. 6. pp. 1025-1029.
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abstract = "Cancer survivors experience treatment-related complications that can be exacerbated by tobacco use. This study reports the prevalence of smokeless and dual tobacco use, compares these rates to the U.S. population, and examines tobacco risk factors among males surviving childhood cancer. Data from the Childhood Cancer Survivor Study (CCSS) 2007 survey were used (N = 3378). Standardized incidence ratios (SIR) were obtained by comparing CCSS data with the National Survey on Drug Use and Health. Logistic regression was used to evaluate associations between risk factors and tobacco use. Amongmale survivors, 8.3{\%} and 2.3{\%} were current smokeless tobacco and dual tobacco users, respectively. Survivors were less likely than population males to report smokeless tobacco [SIR = 0.64; 95{\%} confidence interval (CI), 0.57-0.72) or dual tobacco (SIR = 0.37; CI, 0.29-0.46) use; however, non-White survivors aged 35 to 49 years were more likely to use smokeless tobacco (SIR = 2.32; CI, 1.27-3.90). Smokeless tobacco use was associated (P < 0.05) with younger age at diagnosis, lower education, being married or divorced/separated, and not living in the Northeastern United State, whereas history of cardiovascular- and/or pulmonary-toxic treatment was protective. Dual tobacco use was associated with younger age at diagnosis, lower education, divorce/separation, and high psychologic distress. Having active heart or circulatory conditions was protective. Although smokeless tobacco/dual tobacco use is generally low among childhood cancer survivors, these findings suggest that tobacco use screening should be expanded to include smokeless tobacco use, and that smokeless tobacco-specific education and cessation interventions should be provided to users. Screening and intervening for smokeless tobacco/dual tobacco use in childhood cancer survivors will reduce tobacco-related morbidity and mortality.",
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