Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

1023 — Understanding the Impact of a Cancer Diagnosis on Desire to Quit Smoking among Family Members of Lung Cancer Patients

Fish LJ (Duke University Medical Center) , Bastian LA (Durham VA Medical Center), Lyna P (Duke University Medical Center), Molner S (Duke University Medical Center)

Objectives:
The objective of this research is to examine theoretical constructs of the Teachable Moment (TM) model among family members of lung cancer patients. The TM model proposes that certain life events, such as a family member’s diagnosis of lung cancer, can increase an individual smoker's desire to quit via 1) increased perceived risk, 2) increased emotional response, 3) a change in self image, and 4) high subjective norm for not smoking.

Methods:
Lung cancer patients were identified from four participating sites (Durham VA Medical Center, Duke, University of North Carolina, and University of South Florida hospitals) and asked to identify family members who smoked (n=494). Consenting family members completed a baseline telephone survey.

Results:
The mean age of family members was 47, 85% were white, 56% were female, 52% had less than college education, 36% were the patient’s primary caregiver, 10% were married to the patient, and 63% reported a high desire to quit. Multivariate logistic regression showed that higher perceived risk (OR=2.3, 95% CI=1.4-3.7), feeling bad about yourself because of smoking (OR=3.0, 95% CI=1.9-4.8), strongly agreeing that people important to you think you should quit (OR=2.2, 95% CI=1.2-3.9) were related to desire to quit ( p<.0001). Non-whites were more likely to have a high desire to quit than whites (OR=2.6 95% CI=1.4-4.9). There was a significant interaction between worry and gender, where women with high worry were more likely to have high desire to quit than men and women with low worry (OR= 2.8 95% CI=1.7-4.6).

Implications:
These data suggest that a family member’s diagnosis of lung cancer may be a strong motivator for quitting in that it impacts smokers perceived risk, self image, and subjective norm. Among women, worry is also associated with desire to quit. Theoretically, components of the TM model are related to desire to quit in family members of lung cancer patients and the relationship varies by race and gender.

Impacts:
The Teachable Moment model can provide strong conceptual framework for identifying specific determinants of desire to quit that can be addressed in smoking cessation interventions for family members of cancer patients.