Background: Combustible tobacco use is a known risk factor for several types of cancer including cancers of the head and neck, esophagus, lung, stomach, bladder, pancreas and cervix. Smokeless tobacco use is a known risk factor for cancers of the mouth, tongue, cheek, gum, and esophagus. Continued use of cigarettes, non-cigarette combustible tobacco products, or smokeless tobacco post diagnosis may interfere with treatment as well as increase the chance of developing a second malignancy. In the past, the US Food and Drug Administration (FDA) has designed targeted educational campaigns to prevent and reduce tobacco use among high-risk populations. Information on the prevalence of use among cancer survivors is vital to inform targeted smoking cessation programs.

Methods: We analyzed combined data from the 2012-2014 National Health Interview Survey (NHIS) for tobacco use by cancer status among over 6,000 cancer survivors aged 18 and older. Non-cigarette combustible tobacco products include cigars, pipes, hookahs, bidis or cigarillos. Smokeless tobacco refers to tobacco products which are placed in the mouth or nose and include chewing tobacco, snuff, dip, snus (snoose), or dissolvable tobacco. Current users had used at least 100 cigarettes in their lifetime— or used other non-cigarette combustible tobacco products at least once in their lifetime— and reported current use as “rarely,” “some days” or “every day.” Survey data were weighted to produce national estimates that are representative of the civilian noninstitutionalized US adult population. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level.

Results: More than 1 in 5 cancer survivors were current cigarette smokers. This was significantly higher than the population of persons without a cancer history. More than 1 in every 15 survivors were current users of some form of non-cigarette combustible tobacco product. However, this prevalence was not significantly different from persons without a history of cancer. The current use of smokeless tobacco products among cancer survivors (under 2%) was just over half the prevalence of that of their peers without a history of cancer.

Conclusion: Tobacco use is an important modifiable risk factor for cancer- and non-cancer related morbidity and mortality of cancer survivors, yet its use remains as prevalent among survivors as among persons with no cancer history. Current cigarette use is higher among US cancer survivors compared with persons without a cancer history, and there is no significant difference in the current use of non-cigarette combustible tobacco products between both groups. Findings from this study may be used to discern differences in use of various types of tobacco products among cancer survivors and their peers without a cancer history.

Citation Format: Tainya C. Clarke. Tobacco use among US cancer survivors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1746.