Background: This study investigated the smoking behaviours and cessation rates of recently diagnosed head and neck cancer patients and explored the barriers and facilitators to cessation.
Methods: A mixed methods explanatory design was utilised. The quantitative data was collected through surveys prior to treatment commencement. The current smokers were followed up after treatment to determine their smoking status. One-on-one, semi-structured interviews were then conducted, and thematic analysis performed.
Results: A total of 64 participants were recruited. The quantitative analysis revealed that participants who were current smokers were more likely to live in a rural location (p = 0.015), have lower levels of education (p = 0.047), and report reduced social and family well-being (p = 0.005) when compared with those who were former or never smokers. The 7-day point prevalence cessation rate was 72% at 1-month follow-up and 67% at 3 months, while continuous smoking cessation was 54% at 1 month and 42% at 3 months. Participants who continued smoking were found to consume more alcohol (p = 0.032), be in the pre-contemplative or contemplative stage of change (p = 0.012), rate their likelihood of ceasing as lower (p = 0.004) and have higher psychological distress (p = 0.052). The qualitative analysis revealed 5 key themes associated with smoking cessation: the teachable moment of a cancer diagnosis and treatment, willpower and cessation aids, psychosocial environment, relationship with alcohol and marijuana, and the interaction between health knowledge and beliefs surrounding smoking and cancer.
Conclusions: This study demonstrates that the majority of head and neck cancer patients are able to achieve smoking cessation, but relapses are common. Future cessation programs should involve regular sessions, be provided by an in-hospital support person and be comprehensive and multi-factorial in nature, addressing co-morbid factors such as alcohol, marijuana and depression.