Smoking prevalence and cessation in skin cancer survivors: A cross-sectional survey

Summary: Smoking is associated with poor prognosis among melanoma survivors, but smoking prevalence and cessation in skin cancer survivors are not well characterized. This cross-sectional study aimed to estimate smoking prevalence and cessation in US adult skin cancer survivors aged 18-84 years using the nationally representative 2020 and 2022 National Health Interview Survey. Weighed prevalence of current smoking within 30 days of survey, smoking at the time of first cancer diagnosis, and smoking cessation after first cancer diagnosis were estimated and compared with internal cancer using Rao-Scott chi-squared tests and multivariable logistic regression. Survivors of multiple cancers were excluded. Compared to internal cancer survivors (n=3782), skin cancer survivors (n=1908) were older (mean age 64.7 vs 62.8 years) and more college educated (46.6% vs 32.6%). Comparing skin cancer survivors with internal cancer survivors, current smoking was less common (9.0% vs 12.9%, p<0.001), smoking at the time of cancer diagnosis did not significantly differ (34.8% vs 40.2%, p=0.06), and post-diagnosis smoking cessation was more prevalent (42.3% vs 31.0%, p=0.01). Prevalence odds of current smoking (OR 0.99, 95% CI 0.66-1.35), smoking at time of diagnosis (1.19, 0.86-1.66), or cessation after diagnosis (1.04, 0.61-1.80) did not differ in skin cancer survivors as compared to internal cancer survivors after adjusting for age, race/ethnicity, sex, household income, health insurance, and education. Limitations include self-reported smoking outcomes. A substantial minority of skin cancer survivors smoke at the time of and after diagnosis. Dermatologists should provide smoking cessation counseling and facilitate referral to evidence-based smoking cessation interventions to skin cancer survivors who smoke. Andrew H. Cheng², Courtney A. Smith¹, Howa Yeung¹ 1. Dermatology, Emory University School of Medicine, Atlanta, GA, United States. 2. Medical Partnership Program, Augusta University, Athens, GA, United States. Minoritized Populations and Health Disparities Research