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E-cigarette and cigarette use among cancer survivors versus general population: a case-control study in Korea

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Abstract

Purpose

Although successful smoking cessation after cancer diagnosis is important, research on e-cigarette use and smoking behavior among cancer survivors (CS) is limited. This study compared cigarette and e-cigarette use among CS and non-cancer populations in Korea.

Methods

This study analyzed the 2013–2018 National Health and Nutrition Survey data to investigate e-cigarette use and smoking behavior among Korean CS. The data were categorized into 1260 CS and 5040 non-cancer populations using the propensity score matching method. A multiple logistic regression was conducted among CS who previously used cigarettes or e-cigarettes to evaluate factors influencing successful cessation.

Results

Regarding conventional smoking, the proportion of ex-smokers was higher (25.2% versus 19.9%) than current smokers (6.7% versus 10.6%) in the CS group than in the propensity matched non-cancer population (PMNCP) (p < 0.001). However, ever use of e-cigarettes did not differ between them (2.4% versus 2.7%, p = 0.529). Successful cessation, defined as not using either cigarettes or e-cigarettes, correlated with problem drinking (OR 0.442, 95% CI 0.207–0.940), depression (OR 0.276, 95% CI 0.087–0.872), and cancer sites. CS of stomach, liver, colorectal, and lung cancer maintained higher successful smoking cessation rates than PMNCP.

Conclusions

Korean CS had a higher cessation rate than PMNCP regarding conventional smoking; however, there was no difference in e-cigarette use.

Implications for Cancer Survivors

In Korea, some CS continue to use e-cigarettes, and physicians should focus on helping them quit. Individualized and timely interventions should be provided for both cigarette and e-cigarette users, considering factors influencing successful cessation.

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References

  1. Mullan F. Seasons of survival: reflections of a physician with cancer. N Engl J Med. 1985;313(4):270–3.

    Article  CAS  PubMed  Google Scholar 

  2. SEER Cancer Statistics Review, 1975-2017. National Cancer Institute, 2020. Available from: http://seer.cacner.gov/1975_2017/. Accessed 6 Jan 2021.

  3. Korea Central Cancer Registry, National Cancer Center. Annual report of cancer statistics in Korea in 2017, Ministry of Health and Welfare. 2020. Available from: http://ncc.re.kr/. Accessed 5 Jan 2021.

  4. Korea Central Cancer Registry, National Cancer Center. Annual report of cancer statistics in Korea in 2007, Ministry of Health and Welfare. 2010. Available from: http://ncc.re.kr/. Accessed 5 Jan 2021.

  5. Travis LB, Rabkin CS, Brown LM, Allan JM, Alter BP, Ambrosone CB, et al. Cancer survivorship--genetic susceptibility and second primary cancers: research strategies and recommendations. J Natl Cancer Inst. 2006;98(1):15–25.

    Article  PubMed  Google Scholar 

  6. Curtis RE, Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr. (eds). New malignancies among cancer survivors: SEER Cancer Registries, 1973-2000. National Cancer Institute. NIH Publ. No. 05-5302. Bethesda, MD, 2006.

  7. Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer. 2004;101(8):1712–9.

    Article  PubMed  Google Scholar 

  8. Shin DW, Kim YW, Oh JH, Kim SW, Chung KW, Lee WY, et al. Knowledge, attitudes, risk perception, and cancer screening behaviors among cancer survivors. Cancer. 2011;117(16):3850–9.

    Article  PubMed  Google Scholar 

  9. in U.S. Department of Health and Human Services. The health consequences of smoking-50 years of progress: a report of the surgeon general. 2014, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health: Atlanta.

  10. Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ. 2010;340:b5569.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Burris JL, Studts JL, DeRosa AP, Ostroff JS. Systematic review of tobacco use after lung or head/neck cancer diagnosis: results and recommendations for future research. Cancer Epidemiol Biomark Prev. 2015;24(10):1450–61.

    Article  CAS  Google Scholar 

  12. Gallaway MS, Glover-Kudon R, Momin B, Puckett M, Lunsford NB, Ragan KR, et al. Smoking cessation attitudes and practices among cancer survivors - United States, 2015. J Cancer Surviv. 2019;13(1):66–74.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Paul CL, Tzelepis F, Boyes AW, D’Este C, Sherwood E, Girgis A. Continued smoking after a cancer diagnosis: a longitudinal study of intentions and attempts to quit. J Cancer Surviv. 2019;13(5):687–94.

    Article  PubMed  Google Scholar 

  14. Hawkins ML, Buys SS, Gren LH, Simonsen SE, Kirchhoff AC, Hashibe M. Do cancer survivors develop healthier lifestyle behaviors than the cancer-free population in the PLCO study? J Cancer Surviv. 2017;11(2):233–45.

    Article  PubMed  Google Scholar 

  15. Pommerenke A, Alberg A, Brandon TH, Croghan I, Cummings MK, Dresler C, et al. Physician preferences in tobacco cessation support for cancer patients: A survey of physicians at National Cancer Institute Designated Cancer Centers. In proceedings of the AACR annual meeting 2014, San Diego, CA, USA, 5-9 April 2014.

  16. Kasza KA, Ambrose BK, Conway KP, Borek N, Taylor K, Goniewicz ML, et al. Tobacco-product use by adults and youths in the United States in 2013 and 2014. N Engl J Med. 2017;376(4):342–53.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Salloum RG, Huo J, Lee JH, Lee J, Dallery J, George T, et al. Tobacco and E-cigarette use among cancer survivors in the United States. PLoS One. 2019;14(12):e0226110.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res. 2011;46(3):399–424.

    Article  Google Scholar 

  19. Kruse GR, Kalkhoran S, Rigotti NA. Use of electronic cigarettes among U.S. adults with medical comorbidities. Am J Prev Med. 2017;52(6):798–804.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Symes YR, Ribisl KM, Boynton MH, Westmaas JL, Mayer DK, Golden SD. Dual cigarette and e-cigarette use in cancer survivors: an analysis using Population Assessment of Tobacco Health (PATH) data. J Cancer Surviv. 2019;13(2):161–70.

    Article  PubMed  Google Scholar 

  21. World Health Organization. WHO report on the global tobacco epidemic. World Health Organization. 2017. Available from: http://www.who.int/tobacco/surveillance/policy/country_profile/kor.pdf?ua=1. Accessed 13 Feb 2021.

  22. Adkison SE, O'Connor RJ, Bansal-Travers M, Hyland A, Borland R, Yong HH, et al. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med. 2013;44(3):207–15.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Du Y, et al. Association of electronic cigarette regulations with electronic cigarette use among adults in the United States. JAMA Netw Open. 2020;3(1):e1920255.

    Article  PubMed  PubMed Central  Google Scholar 

  24. World Health Organization Framework Convention on Tobacco Control, DECISION. Fifth plenary meeting, 18 October 2014. apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6(9)-en.pdf. Accessed 14 Feb 2021.

  25. World Health Organization. Progress report on regulatory and market developments on electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems. (ENNDS) [Internet]. Geneva:World Health Organization. August 2016. https://www.who.int/fctc/cop/sessions/cop8/FCTC_COP_8_10-EN.pdf. Accessed 26 Apr 2021.

  26. Kennedy RD, Awopegba A, de León E, Cohen JE. Global approaches to regulating electronic cigarettes. Tob Control. 2017;26(4):440–5.

    Article  PubMed  Google Scholar 

  27. Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23(2):133–9.

    Article  PubMed  Google Scholar 

  28. Callahan-Lyon P. Electronic cigarettes: human health effects. Tob Control. 2014;23(Suppl 2):ii36–40.

    Article  PubMed  Google Scholar 

  29. Shen Y, Wolkowicz MJ, Kotova T, Fan L, Timko MP. Transcriptome sequencing reveals e-cigarette vapor and mainstream-smoke from tobacco cigarettes activate different gene expression profiles in human bronchial epithelial cells. Sci Rep. 2016;6:23984.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Ghosh A, Coakley RC, Mascenik T, Rowell TR, Davis ES, Rogers K, et al. Chronic e-cigarette exposure alters the human bronchial epithelial proteome. Am J Respir Crit Care Med. 2018;198(1):67–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Lerner CA, Sundar IK, Yao H, Gerloff J, Ossip DJ, McIntosh S, et al. Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung. PLoS One. 2015;10(2):e0116732.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  32. Hartmann-Boyce J, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2016;9:CD010216.

    PubMed  Google Scholar 

  33. United States Public Health Service Office of the Surgeon, G., et al., Publications and reports of the surgeon general, in smoking cessation: a report of the surgeon general. 2020, US Department of Health and Human Services: Washington (DC) a conflict of interest disclosure form. Unless otherwise noted below, no potential conflicts of interest were reported. Dr. Glenda Lassi reports being employed by AstraZeneca, a research-based biopharmaceutical company. Dr. Marcus R. Munafò reports receiving grant funding from Pfizer and Rusan Pharma and obtaining products for use in research from GlaxoSmithKline, a company that manufactures smoking cessation products. Dr. Judith J. Prochaska reports having served as an ad hoc advisor to Pfizer Inc, a company that manufactures smoking cessation medications.

  34. Force, U.S.P.S.T, et al. Interventions for tobacco smoking cessation in adults, including pregnant persons: US preventive services task force recommendation statement. JAMA. 2021;325(3):265–79.

    Article  Google Scholar 

  35. Berg CJ, Thomas AN, Mertens AC, Schauer GL, Pinsker EA, Ahluwalia JS, et al. Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Psychooncology. 2013;22(4):799–806.

    Article  PubMed  Google Scholar 

  36. Vander Ark W, DiNardo LJ, Oliver DS. Factors affecting smoking cessation in patients with head and neck cancer. Laryngoscope. 1997;107(7):888–92.

    Article  CAS  PubMed  Google Scholar 

  37. Tseng T-S, Lin HY, Moody-Thomas S, Martin M, Chen T. Who tended to continue smoking after cancer diagnosis: the national health and nutrition examination survey 1999–2008. BMC Public Health. 2012;12(1):784.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Westmaas JL, Alcaraz KI, Berg CJ, Stein KD. Prevalence and correlates of smoking and cessation-related behavior among survivors of ten cancers: findings from a nationwide survey nine years after diagnosis. Cancer Epidemiol Biomark Prev. 2014;23(9):1783–92.

    Article  Google Scholar 

  39. Gritz ER, Talluri R, Fokom Domgue J, Tami-Maury I, Shete S. Smoking behaviors in survivors of smoking-related and non–smoking-related cancers. JAMA Netw Open. 2020;3(7):e209072.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Park JJ, Park HA. Prevalence of cigarette smoking among adult cancer survivors in Korea. Yonsei Med J. 2015;56(2):556–62.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Antwi GO, Lohrmann DK, Jayawardene W, Chow A, Obeng CS, Sayegh AM. Associations between e-cigarette and combustible cigarette use among U.S. cancer survivors: implications for research and practice. J Cancer Surviv. 2019;13(2):316–25.

    Article  PubMed  Google Scholar 

  42. Jackson I, Osaghae I, Etuk A, Jackson N. Prevalence and factors associated with electronic cigarette use among young adult cancer survivors usingbehavioral risk factor surveillance system, 2016-2018. J Adolesc Young Adult Oncol. 2020. https://doi.org/10.1089/jayao.2020.0104.

  43. Mehra VM, Keethakumar A, Bohr YM, Abdullah P, Tamim H. The association between alcohol, marijuana, illegal drug use and current use of E-cigarette among youth and young adults in Canada: results from Canadian Tobacco, Alcohol and Drugs Survey 2017. BMC Public Health. 2019;19(1):1208.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Roberts W, Moore KE, Peltier MKR, Verplaetse TL, Oberleitner L, Hacker R, et al. Electronic cigarette use and risk of harmful alcohol consumption in the U.S. population. Alcohol Clin Exp Res. 2018;42(12):2385–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. DiFranza JR, Guerrera MP. Alcoholism and smoking. J Stud Alcohol. 1990;51(2):130–5.

    Article  CAS  PubMed  Google Scholar 

  46. Batel P, et al. Relationship between alcohol and tobacco dependencies among alcoholics who smoke. Addiction. 1995;90(7):977–80.

    Article  CAS  PubMed  Google Scholar 

  47. Daeppen J-B, Smith TL, Danko GP, Gordon L, Landi NA, Nurnberger JI Jr, et al. Clinical correlates of cigarette smoking and nicotine dependence in alcohol-dependent men and women. Alcohol Alcohol. 2000;35(2):171–5.

    Article  CAS  PubMed  Google Scholar 

  48. Park EM, Rosenstein DL. Depression in adolescents and young adults with cancer. Dialogues Clin Neurosci. 2015;17(2):171–80.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Obisesan OH, Mirbolouk M, Osei AD, Orimoloye OA, Uddin SMI, Dzaye O, et al. Association between e-cigarette use and depression in the behavioral risk factor surveillance system, 2016-2017. JAMA Netw Open. 2019;2(12):e1916800.

    Article  PubMed  PubMed Central  Google Scholar 

  50. National Comprehensive Cancer Network. Smoking Cessation (Version 1.2021). Available from: https://www.nccn.org/professionals/physician_gls/pdf/smoking.pdf. Accessed 22 Feb 2021.

  51. Morgan G, Schnoll RA, Alfano CM, Evans SE, Goldstein A, Ostroff J, et al. National cancer institute conference on treating tobacco dependence at cancer centers. J Oncol Pract. 2011;7(3):178–82.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Schnoll RA, Malstrom M, James C, Rothman RL, Miller SM, Ridge JA, et al. Correlates of tobacco use among smokers and recent quitters diagnosed with cancer. Patient Educ Couns. 2002;46(2):137–45.

    Article  PubMed  Google Scholar 

  53. Karam-Hage M, Cinciripini PM, Gritz ER. Tobacco use and cessation for cancer survivors: an overview for clinicians. CA Cancer J Clin. 2014;64(4):272–90.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Mayer DK, Carlson J. Smoking patterns in cancer survivors. Nicotine Tob Res. 2011;13(1):34–40.

    Article  CAS  PubMed  Google Scholar 

  55. Tseng TS, Lin HY, Martin MY, Chen T, Partridge EE. Disparities in smoking and cessation status among cancer survivors and non-cancer individuals: a population-based study from National Health and Nutrition Examination Survey. J Cancer Surviv. 2010;4(4):313–21.

    Article  PubMed  Google Scholar 

  56. Underwood JM, Townsend JS, Tai E, White A, Davis SP, Fairley TL. Persistent cigarette smoking and other tobacco use after a tobacco-related cancer diagnosis. J Cancer Surviv. 2012;6(3):333–44.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Jha P, Ranson MK, Nguyen SN, Yach D. Estimates of global and regional smoking prevalence in 1995, by age and sex. Am J Public Health. 2002;92(6):1002–6.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Desai MM, Bruce ML, Desai RA, Druss BG. Validity of self-reported cancer history: a comparison of health interview data and cancer registry records. Am J Epidemiol. 2001;153(3):299–306.

    Article  CAS  PubMed  Google Scholar 

  59. Alberg AJ, Worley ML, Tooze JA, Hatcher JL, Carpenter MJ, Day TA, et al. The validity of self-reported recent smoking in head and neck cancer surgical patients. Otolaryngol Head Neck Surg. 2015;153(6):990–5.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

The authors would like to thank the Korea Centers for Disease Control and Prevention, which conducted the KNHANES.

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Availability of data and material

The raw data of survey is available in a public, open access repository (http://knhanes.cdc.go.kr/). The datasets generated during and/or analyzed during this study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Department of Family Medicine, SanggyePaik Hospital, Seoul, Korea

    Jeongki Paek

  2. Department of Biostatistics, Korea University College of Medicine, Seoul, Korea

    Serhim Son

  3. Division of Hematology/Oncology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

    Yoon Ji Choi

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  1. Jeongki Paek
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  2. Serhim Son
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  3. Yoon Ji Choi
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Contributions

Jeongki Paek: contributed to the study design, data analysis, data interpretation, and manuscript writing

Serhim Son: data collection, data analysis, and manuscript writing

Yoon Ji Choi: conceived the study question, contributed to the study design, supervised data collection, data analysis and interpretation, and manuscript writing

Corresponding author

Correspondence to Yoon Ji Choi.

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Ethics approval

The 2013–2018 KNHANES was reviewed and approved by the Institutional Review Board of the Korea Centers for Disease Control and Prevention.

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Informed consent was obtained from all participants included in the KNHANES.

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All authors consent to publish this study.

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The authors declare no competing interests.

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Paek, J., Son, S. & Choi, Y.J. E-cigarette and cigarette use among cancer survivors versus general population: a case-control study in Korea. J Cancer Surviv 16, 741–750 (2022). https://doi.org/10.1007/s11764-021-01067-x

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  • DOI: https://doi.org/10.1007/s11764-021-01067-x

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