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Smoking cessation prolongs survival in female cancer survivors - the Danish nurse cohort

  • Jette Heberg
    Correspondence
    Corresponding author. Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark.
    Affiliations
    Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark

    Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark
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  • Mette Kildevæld Simonsen
    Affiliations
    The Parker Institute, Bispebjerg and Frederiksbergs Hospital, Region H, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark

    Aarhus University, Health, Department of Public Health, Vennelyst, Boulevard 4, 8000, Aarhus C, Denmark
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  • Thordis Thomsen
    Affiliations
    Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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  • Vibeke Zoffmann
    Affiliations
    Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark

    University of Copenhagen, IFSV, Section of Health Services Research, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
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  • Anne Kjaergaard Danielsen
    Affiliations
    Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark

    University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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      Highlights

      • Smoking cessation yields considerable survival benefits in cancer surviving nurses.
      • Cancer-diagnosed nurses (vs cancer-free) hold increased chance of smoking cessation.
      • The time around cancer diagnosis may offer a teachable moment for smoking cessation.
      • Ongoing priority should be given to smoking cessation in oncology care.

      Abstract

      Purpose

      To explore smoking cessation between cancer survivors and cancer-free women, and the potential survival benefits from smoking cessation in cancer surviving women.

      Method

      We pooled 46,334 responses from the Danish Nurse Cohort. The cohort consists of female nurses, who were invited for surveys in 1993, 1999 and 2009. Participants were linked to nationwide registries on hospitalization, cause of death and migration through 2016. Odds for smoking cessation by cancer diagnosis were computed in propensity score matched logistic regression models, while survival by postdiagnosis smoking cessation was estimated in cox proportional hazards models.

      Results

      Eligible for analysis were 7841 women (mean age = 56.7 years, SD ± 7.2), who were smokers at baseline and survived to the next follow-up survey. Of these, 545 women were diagnosed with cancer and matched by propensity score (1:2) with 1090 cancer-free women. Odds for smoking cessation were significantly higher in cancer-diagnosed women compared to their cancer-free peers (OR = 1.31, 95% CI: 1.06–1.61). Moreover, mortality risk was significantly lower among cancer survivors who stopped smoking (HR = 0.64, 95% CI: 0.46–0.91), compared to persistent smokers.

      Conclusions

      The results suggest considerable survival benefits from smoking cessation in cancer surviving female nurses, and that the time surrounding cancer diagnosis may serve as a teachable moment for smoking cessation. However, due to substantial methodological limitations embedded in the study, careful interpretation of the presented results is warranted. Future studies are needed to demonstrate the effects of diagnosis on smoking cessation as well as the effects of smoking cessation on survival in female cancer populations.

      Keywords

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