A comparison of tobacco-related risk factors between preadolescents with and without cancer.

INTRODUCTION: To compare preadolescents with and without cancer on current smoking status, future intentions to smoke, and tobacco-related risk factors, as well as to explore the relationship between cancer status and tobacco-related variables with intentions. PROCEDURE: Ninety-four preadolescents undergoing treatment for cancer and a matched comparison sample of 190 participants without cancer, ages 8 to 11 years, completed questionnaires about their smoking habits, intentions to smoke and tobacco-related psychosocial risk factors. RESULTS: No preadolescents with cancer and only two preadolescents without cancer reported current smoking. Compared to healthy nonsmoking preadolescents, nonsmokers with cancer were approximately one-half as likely to report future intentions to smoke. Intention to smoke was better predicted by variables most proximal to smoking including older age, being male, not having cancer, having close friends who smoke, parental smoking, and lower perceived vulnerability for tobacco-related illnesses. In the model examining distal variables, preadolescents who were more rebellious, older, and without cancer were more likely to report future smoking intentions. DISCUSSION/CONCLUSIONS: Although future intentions to smoke differed according to cancer status, the relationship between tobacco-related risk factors and future smoking intentions appeared to be similar among preadolescents with and without cancer. IMPLICATIONS FOR CANCER SURVIVORS: Smoking prevention and tobacco-related health risk education should begin during the elementary years, a time prior to smoking initiation and the development of solidified smoking attitudes. The diagnosis and treatment of pediatric cancer may provide an excellent opportunity for health care providers to begin communicating anti-smoking messages and health risk counseling to their young patients and families.

Anti-Smoking Communication to Preadolescents with and without a Cancer Diagnosis: Parents and Healthcare Providers as Important Communicators.

A cancer diagnosis does not prevent smoking among pediatric oncology patients, and anti-smoking communications among parents and health care providers have been proposed as influencing smoking outcomes in this group. Anti-smoking communications were compared among 93 preadolescents with cancer and 402 controls. After adjusting for demographics and covariates, preadolescents with cancer were less likely than control participants to report receipt of anti-smoking messages from physicians and parents, and recalled more messages >/= 4 months post-diagnosis as compared to 1-3 months. Should anti-tobacco communications prove to influence smoking outcomes, parents and physicians may be uniquely positioned to provide smoking prevention interventions to these patients.

Smoking rates and the state of smoking interventions for children and adolescents with chronic illness.

Engaging in smoking is particularly risky for children and adolescents with chronic illness whose health status is already compromised because of disease- and treatment-related complications. Yet, some of these youngsters smoke at rates at least comparable to those of their healthy peers. To date, few randomized smoking-prevention and cessation trials have been conducted in children with chronic medical problems. In this review we report on the smoking rates among youngsters with chronic illness, identify specific disease- and treatment-related complications that can be exacerbated by smoking, examine risk factors associated with tobacco use among medically compromised youngsters, and review smoking interventions that have been conducted to date with pediatric populations in the health care setting. The following chronic illnesses are included in this review: asthma, cystic fibrosis, cancer, sickle cell disease, juvenile-onset diabetes, and juvenile rheumatoid arthritis. Objectives for a tobacco-control agenda and recommendations for future tobacco studies in chronically ill pediatric populations are provided. Finally, tobacco counseling strategies are suggested for clinicians who treat these youngsters in their practices.

Smoking among parents of pediatric cancer patients and children's exposure to environmental tobacco smoke.

For 303 children newly diagnosed with cancer, we investigated the prevalence of parental smoking and examined patients' respiratory or pulmonary symptoms according to household smoking status. Results indicated that approximately 45 percent of patients came from households with at least one current parent smoker and 20 percent of current non-smoking parents reported past tobacco use. There was a trend for more patients from smoking households to experience respiratory problems than patients from non-smoking households (p = .068). In conclusion, many patients are at risk for parental smoke exposure and associated health problems if they are continually exposed during therapy. Clinician-delivered interventions to reduce environmental smoke exposure are clearly warranted.

Parent-reported environmental tobacco smoke exposure among preadolescents and adolescents treated for cancer.

Exposure to environmental tobacco smoke (ETS) poses serious health risks for children with cancer. Parental smoke is a primary source of exposure for these children. Parent smoking behaviors and parent-reported ETS exposure among children treated for cancer were examined in this study. In addition, reports of ETS exposure among children with cancer who currently smoked or who had smoked in the past were compared to those of children with cancer who never smoked. Written questionnaires about smoking behaviors and ETS exposure were administered to 47 smoking parents of youngsters diagnosed with cancer, 10-18 years of age (57.4% male, 78.7% Caucasian). Child reports of smoking status were also obtained. Results indicated that children with cancer are exposed to ETS from a number of sources and settings, as reported by their parents. Current or previous child smokers had greater ETS exposure than non-smoking children. Older children and Caucasian children also had greater ETS exposure. Level of ETS exposure did not differ based on the child's treatment status. Interventions that teach parents to protect their youngster from ETS exposure have potential for reducing adverse health outcomes in this vulnerable population.