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(Chest. 2006;130:1784-1790.)
© 2006 American College of Chest Physicians

Smoking Cessation After Diagnosis of Lung Cancer Is Associated With a Beneficial Effect on Performance Status*

Sevin Baser, MD; Vickie R. Shannon, MD, FCCP; Georgie A. Eapen, MD; Carlos A. Jimenez, MD; Amir Onn, MD; E Lin, MS and Rodolfo C. Morice, MD, FCCP

* From the Departments of Pulmonary Medicine (Drs. Baser, Shannon, Eapen, Jimenez, Onn, and Morice), and Biostatistics and Applied Mathematics (Ms. Lin), The University of Texas M. D. Anderson Cancer Center, Houston, TX.

Correspondence to: Sevin Baser, MD, Department of Pulmonary Medicine, Unit 403, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; e-mail: basersevin{at}yahoo.com

Abstract

Study objective: To evaluate the impact of smoking history and postdiagnosis smoking cessation on performance status (PS) and survival in patients with lung cancer.

Design: Patients with non-small cell lung cancer (NSCLC) who were referred to our pulmonary laboratory for evaluation for surgical resectability between January and November 2001 were reviewed. We investigated the association between smoking status after diagnosis and survival, as well as the change in PS from the initial status to status at 6 and 12 months after the diagnosis was established.

Results: The records were reviewed for 206 patients, of whom 93 (45%) were current smokers, 15 (7%) were never-smokers, and 98 (48%) were former smokers. Among the 93 smokers, 46 quit and 47 continued smoking after the diagnosis. Disease stage, patient demographics, treatment modalities, and comorbidities were similar between these two groups. While there was no significant association between smoking status after diagnosis and patient survival, those who quit smoking maintained a better PS at 0 to 6 months (odds ratio [OR], 7.09; 95% confidence interval [CI], 1.99 to 25.3; p = 0.002) and at 0 to 12 months (OR, 6.99; 95% CI, 1.76 to 27.7; p = 0.006) than those who continued smoking after the adjustment for disease stage, patient demographics, treatment modalities, and comorbidities.

Conclusion: Patients who quit smoking after the diagnosis of NSCLC maintained a better PS at 6 and 12 months regardless of disease stage, age, race, sex, therapy types, and comorbidities than those who continued to smoke.

Key Words: non-small cell lung cancer • performance status • smoking • survival






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