| Summary: | Background
Previous studies indicate that quitting smoking
significantly improves health-related quality of life (QOL) in patients with
lung and head and neck cancer. However, few prospective studies have
investigated the role of smoking status on QOL across patients diagnosed with a
wide range of cancers. The aim of the present study was to examine quality of
life (depression, pain, and fatigue) changes over time as a function of smoking
status.
Methods
Participants were 351 cancer patients (e.g.,
gynecological, breast, thoracic, head and neck, genitourinary, hematological,
cutaneous) who reported smoking abstinence within the previous 120 days.
Smoking status and QOL (depression, pain severity, fatigue severity, and
fatigue interference) were assessed at baseline, 2, 6, and 12 month follow-ups.
Within a Structural Equation Modeling (SEM)
framework, growth curve models with smoking status as a time varying covariate were
employed to examine the effect of smoking status change in QOL measures over
time. Baseline demographics (e.g., sex, income) and smoking history (e.g.,
nicotine dependence) were controlled.
Results
Overall, models with both time-varying
covariates (smoking status) and time-invariant covariates (demographics,
nicotine dependence) were good-to-excellent fits with the data. Smoking status
had a main effect and an interaction with time upon depression and pain
severity. For fatigue severity and fatigue interference, smoking status interacted
with time, i.e., smoking abstinence at the 6 and 12 months follow-ups were
associated with lower fatigue scores across the estimated growth curve.
Conclusions
These results extend previous findings showing that QOL improves in cancer patients who quit smoking. Specifically, patients who quit smoking experience a greater reduction in depression and pain levels at all time points, and the reduction increases over time. In the case of fatigue, the results suggest that patients experience the greatest improvement with longer (≥ 4 months) abstinence.
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