Smoking cessation after a diagnosis of lung cancer is associated with improved outcomes, including quality of life and survival. The research presented here is based on data obtained from sequential interviews with early stage lung cancer patients in Kentucky, on their smoking patterns at four time points: (1) six months before enrollment in the study, before diagnosis, (2) at enrollment (shortly after surgical resection), (3) three months post-enrollment, and (4) six months post-enrollment. A number of covariates were considered to examine the factors associated with smoking abstinence and rebound trajectories. The results indicate that, while about 75% of patients who were smoking at six months before enrollment had quit by the first post-surgery interview, almost 50% of them had returned to smoking six months later. Multivariate analysis to evaluate the relative contribution of covariates indicated that low household income, exposure to environmental tobacco smoke at home and evidence of depression were positively associated with returning to smoking. Furthermore, even after controlling for these factors, patients from the Appalachian region of Kentucky, an area with substantially high smoking prevalence and very high lung cancer incidence rates, were less likely to abstain from smoking throughout the study than subjects in the rest of the state. Future research is suggested to investigate in more detail the tobacco-related behaviors and cessation attempts of patients and their families, which can lead to more targeted, successful smoking cessation interventions for lung cancer patients.
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