Predictive Factors for Smoking Cessation Among People With Lung Cancer Attending French Cessation Services, According to Sex.

BACKGROUND

Limited research exists on sex-specific smoking cessation interventions for patients with lung cancer. This study leverages data from the Consultations de Dépendance Tabagique, the French national database of smoking cessation services (SCS), to identify sex-specific factors influencing smoking cessation in people with lung cancer.

METHODS

This retrospective observational study analyzed data from 3407 adults with lung cancer (31.2% women, 68.8% men) registered in the Consultations de Dépendance Tabagique between 2001 and 2018. Participants were people with active tobacco use with at least one follow-up SCS consultation. The primary outcome was 28-day smoking abstinence, confirmed by exhaled carbon monoxide less than 10 parts per million. Multivariate logistic regression identified predictors of abstinence, stratified by sex.

RESULTS

Abstinence rates were similar in women (35.2%) and men (35.4%) (p = 0.40). Women had higher psychological distress (19.8% with depression versus 13.1% in men; p < 0.001) and were more likely to seek SCS independently (19.4% versus 13.6%; p < 0.001). Men smoked more cigarettes daily (27 versus 25; p = 0.002) and had higher alcohol consumption (35.7% versus 13.9%; p < 0.001). Confidence in quitting (women: odds ratio [OR] = 1.91; 95% confidence interval [CI]: 1.27-2.87; men: OR = 1.50; 95% CI: 1.16-1.95) and follow-up consultations (≥7: women: OR = 8.86; 95% CI: 5.69-14.0; men: OR = 6.64; 95% CI: 4.88-9.13) predicted abstinence for both sexes. Among women, hospital referral (OR = 1.63; 95% CI: 1.10-2.43) and living with other persons who smoke (OR = 4.16; 95% CI: 1.70-10.4) increased abstinence, whereas in men, nicotine replacement therapy (OR = 1.46; 95% CI: 1.09-1.97) was beneficial.

CONCLUSIONS

The results indicate a need for further research into targeted interventions by sex to evaluate the efficacy of smoking cessation strategies in patients with lung cancer.