• 5/3/2002
  • Michigan
  • Sonia Duffy, Ph.D., R.N.
  • Center for the Advancement of Health

Even a bout with head and neck cancer cannot stop some people from smoking, despite many indicating that they want to quit, according to a new study.

Head and neck cancer patients who continue to smoke also score substantially lower on measures of quality of life than those who have kicked the habit, according to the study published in the April issue of the journal General Hospital Psychiatry. “Despite the known risk of continued smoking in patients with head and neck cancer, over one-quarter of the head and neck cancer patients continued to smoke; most of them smoked more than half a pack per day,” says lead author Sonia Duffy, Ph.D., R.N., of the VA Ann Arbor Healthcare System and the University of Michigan.

The American Cancer Society estimates that there were more than 30,000 new cases of head and neck cancers last year. Eighty-five percent of cases are associated with tobacco use, according to government statistics.

The researchers recruited 81 non-terminal head and neck cancer patients, most of whom were white and male, from the VA and university hospital. They answered questionnaires on smoking, drinking and depression as well as quality of life. The study revealed that 23 percent of the patients were current smokers and 35 percent had smoked in the past six months. The study also found that nearly half of the patients (46 percent) continued to drink alcohol, although the combination of smoking and alcohol consumption creates an even-greater risk for such cancers, the researchers say. Depression was also prevalent among these patients, with 44 percent showing significant signs of the condition. Both smoking and depression were associated with significantly poorer quality of life on measures such as physical functioning, general health, social functioning and emotional health. Alcohol use was not associated with poorer quality of life, although it was associated with a greater likelihood of smoking.

Consistent with these results, about a third of the smokers and the depressed patients said they would welcome interventions for these problems, while less than 10 percent of those who continued to drink said they wanted help to stop using alcohol. “Perhaps in no other group of oncology patients are quality of life factors as important as in head and neck cancer patients, who suffer from debilitating speech, eating and respiratory problems as well as the psychological effects of loss of functioning and change in body image,” say the researchers.

They note that while difficulty coping with their disease can affect patients’ immune systems and even their survival, doctors often become so focused on treating the obvious physiological affects of the cancer that they may overlook these less obvious health issues. The study was funded in part by the Department of Veterans Affairs, the Oncology Nursing Society and Sigma Theta Tau.