• A recent study surveyed cancer survivors on their tobacco and alcohol use and on cessation programs.
• According to the survey, many cancer survivors drink alcohol and do not consider stopping, while many who use tobacco have considered quitting.
• Survey participants noted that smoking-cessation and alcohol-moderation programs need to be positive, emphasize autonomy, and use a nonjudgmental tone.

A recent study investigated how cancer survivors view programs designed to help them stop smoking and moderate their alcohol use. Researchers from the Trimbos Institute in Holland looked at what cancer survivors value most in these programs, and how this information can be used to create successful ones. The study included people who had been diagnosed with some form of cancer and who either currently or formerly smoked, or who currently drink alcohol.

Alcohol, Tobacco, and Cancer

Alcohol and tobacco use both lead to an increased risk of developing cancer — smoking accounts for 80 percent to 90 percent of lung cancer deaths in the United States. However, many cancer survivors still smoke or drink alcohol. According to the Centers for Disease Control and Prevention (CDC), between 9 percent and 18 percent of cancer survivors in the United States smoke cigarettes. A recent survey found that more than half of people continue smoking after undergoing lung cancer surgery. Stress and other psychological factors can lead to cigarette smoking in order to cope.

In a 2020 study from the Journal of the National Comprehensive Cancer Network, 56.5 percent of cancer survivors surveyed currently drank alcohol, and 34.9 percent exceeded moderate drinking limits.

While programs have been created to help cancer survivors curb alcohol and tobacco use, many are ineffective. In fact, one 2019 study found that out of 21 smoking cessation programs for cancer survivors, none were significantly more effective than the results of the study control groups who didn’t use the programs.

With this in mind, the study authors at the Trimbos Institute set out to survey cancer survivors on how they view smoking cessation and alcohol moderation programs and what support they prefer.

Many Cancer Survivors Drink or Smoke

The authors recruited cancer survivors through a Dutch online cancer survivor community, who were then sent an online survey. The survey included questions on alcohol and tobacco use, lifestyle changes they would like to make, and their preferences for support given to cancer survivors. In total, 240 participants responded to the survey.

Researchers reported that 55 percent of the survey participants had smoked in the past, while 12.1 percent currently smoked. Of all of the participants who smoked, 79.3 percent had considered quitting.

At the time of the survey, 77.5 percent of the participants also drank alcohol — 53.2 percent drank at least two times a week. Nearly 85 percent of respondents had not considered reducing or stopping alcohol use.

Of the participants who had tried quitting or moderating their alcohol use, they did so for health reasons or because they could not tolerate drinking during their cancer treatment. Of those who had quit or tried to quit smoking, health was the most common reason cited.

Opinions on Treatment Programs

In the study, almost half of participants who formerly drank alcohol and a third who formerly smoked did not want support for quitting. For participants who did want support, online information, printed flyers, and face-to-face support were the preferred methods.

There were also two sets of focus groups in the study — one set on drinking alcohol and one set on smoking. Participants were asked about their experiences moderating alcohol use and quitting smoking, as well as preferences for support. The researchers also interviewed six experts who were either health care professionals who specialized in smoking and alcohol cessation or people who had developed digital support resources for cancer survivors.

Many of the focus group participants shared that successful smoking cessation and alcohol moderation programs need to be positive, nonjudgmental, and emphasize that the participants have autonomy and can make their own choices.

Participants also said that short-term benefits should be emphasized to increase motivation, and that both digital and face-to-face support options should be offered for people who are uncomfortable sharing health information online.

Overall, the study authors recommended health care professionals talk more about the connection between alcohol and cancer, and emphasize the benefits of limiting or stopping drinking alcohol and smoking. Digital support services may also be useful, but all programs should avoid stigmatizing people who use alcohol or tobacco.