Elsevier

Public Health

Volume 129, Issue 5, May 2015, Pages 545-548
Public Health

Original Research
Poor health among smokers obtaining colonoscopy screening: making the case for cessation intervention

https://doi.org/10.1016/j.puhe.2015.02.004Get rights and content

Abstract

Objectives

Assess differences in perceived health status among individuals receiving colonoscopy screening based on smoking status.

Study design

Cross-sectional data were collected as part of a larger study investigating whether verbal and non-verbal communication and behaviors of gastroenterologists and nurses.

Method

Data for this study were collected between 2011 and 2013 among receiving colonoscopy screenings. Data were collected as part of a study assessing patients (n = 1785) undergoing colonoscopy screenings about their expectations, concerns, understanding of the procedure, and perceived health status. Differences between current, former and never smokers were analyzed using a one-way between subjects ANOVA, with a Scheffe post hoc.

Results

Post hoc analyses revealed that current smokers were significantly different from former or never smokers on the following variables: days their physical health was not good, days their mental health was not good, days health influenced their activities, days pain influenced their ability to perform activities, perceived general health, and current anxiety.

Conclusion

This study looked at perceived health among individuals receiving colonoscopy screening by on smoking status, a relevant population based on the recent Surgeon Generals link. Former smokers reported similar health status across all variables as never smokers, suggesting the effect of quitting smoking on self-perceived health. With this link, tailored smoking cessation messages to smokers receiving colonoscopy screenings may be an excellent vantage point for a smoking cessation intervention.

Introduction

Tobacco products contain a number of carcinogens, with at least 60 associated with cigarette smoke and 16 within unburned tobacco.1 Carcinogenic byproducts of tobacco combustion are largely responsible for high morbidity and mortality rates linked to tobacco use. Smoking has been causally linked to a variety of cancers, including lung, breast, and bladder for a number of years.1 Recently, cigarette smoking was identified as a causal factor for colorectal cancer.1 Colorectal cancer is the third most common cancer and third leading cause of cancer deaths in the USA.1 Studies have shown that smokers are at increased risk for colorectal cancer even after controlling for known risk factors such as family history, alcohol use, and body fat.3, 4, 5

Screenings are recommended for colorectal cancer beginning at age 50 for the general population.6 Regular screening can reduce the number of persons who die from colorectal cancer by at least 60%.6 With the strong link between smoking status and colorectal cancer, screenings represent a key opportunity for a smoking cessation intervention. Studies have assessed smoking cessation interventions among patients receiving cervical and lung cancer screenings as moderately successful.7 However, a literature review revealed no smoking cessation interventions among patients receiving colonoscopy screenings. This paper reports quantitative data comparing perceived health status between current smokers, former smokers and never smokers among patients receiving colonoscopy screenings and then makes the case for colonoscopy screening as an intervention point for a smoking cessation intervention.

Section snippets

Procedures

Data for this study were collected between 2011 and 2013 among 1785 persons receiving colonoscopy screenings. Cross-sectional data were collected as part of a larger study investigating whether verbal and non-verbal communication and behaviors of gastroenterologists & nurses: (a) are associated with how adjuvant chemotherapy is framed by patients and caregivers; (b) differ by patients' race, gender, income, and age; (c) differ by colonoscopy outcomes; and (d) differ by gastroenterologist or

Results

Data were analyzed from 1744 colonoscopy patients: 253 current smokers, 552 former smokers and 939 never smokers (See Table 1). Participants were predominantly Caucasian (77.0%) and female (61.8%), with a mean age of 53.6 (±13.1) years. There was a significant difference in age between groups, with former smokers (M = 57.7, SD = 11.7) significantly older than current (M = 51.0, SD = 10.9) or never smokers (M = 51.8, SD = 13.6) (F = 39.4, df = 2, P < .0001). Additionally, there was a significant

Discussion

This study found that ‘current smokers’ obtaining colonoscopy screenings were significantly more likely to report poorer health status compared to ‘former’ and ‘never smokers.’ Furthermore, perceived health status among five of six measures for people who quit smoking (former smokers) was equivalent to the level of people who had never smoked (never smokers), potentially indicating the effect of quitting smoking on self-perceived health. The literature widely supports the finding that

Acknowledgements

The content is solely the responsibility of the authors and does not necessarily represent the official views of the Bankhead Coley Cancer Research Program.

Ethical approval

This project was approved by the University of Florida Institutional Review Board 01: 166-2011.

Funding

Research reported in this publication was supported by the Bankhead Coley Cancer Research Program under Award Number 1BG01-34188. (B. Curbow, Principal Investigator).

Competing interest

Authors have no conflict of interest to declare. This is an original submission

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