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M.E. Cooley



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    O06 - Cancer Control and Epidemiology I (ID 135)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      O06.04 - The association between having a first-degree family history of cancer and smoking status (ID 1191)

      11:15 - 11:25  |  Author(s): M.E. Cooley

      • Abstract
      • Presentation
      • Slides

      Background
      Smokers with a family history of cancer are at higher risk for developing cancer. A diagnosis of cancer within the family may provide an opportunity for smokers to adopt health-promoting behavior. This study examined associations between having a first-degree family history of cancer and smoking status.

      Methods
      Data from the 2009 California Health Interview Survey (CHIS) on 47,331 adults were used in this cross-sectional study. Sample weights were applied to account for the complex survey design with results generalizable to non-institutionalized adults in California (27.4 million). Smoking status was classified as current, former, or never-smoker. Family cancer history was defined as blood relatives that include biological father or mother, full brothers or sisters, or biological sons or daughters. Demographic characteristics included age, gender, race/ethnicity, marital status, poverty level, education level and health insurance coverage. General health status, physical activity, body weight status and binge drinking status were also included. CHIS defined binge drinking status as ≥5 alcoholic drinks for males or ≥4 alcoholic drinks for females in a single episode in the past year. Body weight status was defined by body mass index as underweight <18.5 kg/m2, normal = 18.5–24.9 kg/m2, overweight = 25.0–29.9 kg/m2, and obesity ≥30.0 kg/m2. Multinomial logistic regression was used to analyze the association between first-degree family history of cancer and smoking status.

      Results
      In 2009, 13.6% (3.7 million) of the 27.4 million adults were current-smokers, 23.0% (6.3 million) former-smokers and 63.4% (17.4 million) never-smokers. Thirty-five percent (9.6 million) had a first-degree family history of cancer (Table 1). Among those with a first-degree family history of cancer, 13.5% (1.3million) were current-smokers, 29.7% (2.8 million) were former-smokers and 56.8% (5.4 million) were never-smokers. Adults with a first-degree family history of cancer were more likely to be former-smokers compared with adults without a first-degree family history of cancer (29.7% vs. 19.3%, p<.001). Controlling for demographic factors and other risk characteristics (binge drinking, obesity, physical activity), having a first-degree family history of cancer was significantly related to being a current-smoker (OR=1.16; 95% CI=1.01-1.34) and former-smoker (OR=1.17; 95% CI 1.05-1.30).

      Table 1: Characteristics of California Health Interview Survey participants, 2009
      Characteristics Unweighted sample size Weighted percentages (95% CI)
      Smoking Status
      Current smokers 5,528 13.6 (12.8-14.4)
      Former Smokers 14,487 23.0 (22.1-23.8)
      Never smokers 27,317 63.4 (62.5-64.3)
      Family Cancer History
      Yes 22,286 35.0 (34.1-35.8)
      No 25,045 65.0 (64.1-65.8)
      Age
      18-25 2,826 16.0 (15.6-16.4)
      26-34 3,446 15.6 (15.0-16.0)
      35-49 10,484 30.2 (29.7-30.5)
      50+ 30,575 38.2 (38.1-38.2)
      Gender
      Male 19,280 49.0 (49.0-49.1)
      Female 28,051 51.0 (50.0-51.0)
      Race/Ethnicity
      Hispanic 8,281 32.5 (32.4-32.5)
      Non-Hispanic White 30,951 46.4(46.4-46.5)
      Non-Hispanic Black 1,839 5.6 (5.6-5.7)
      Non-Hispanic Asian 4,833 12.8 (12.8-13.0)
      Non-Hispanic Other 1,427 2.6 (2.5-2.6)
      Marital Status
      Married 27,079 61.3 (60.5-62.2)
      Not-married 20,252 38.6 (37.8-39.5)
      Federal Poverty Level (FPL)
      < 100% FPL 5,747 16.0 (15.3-16.8)
      100-199 % FPL 7,950 18.0 (17.2-18.7)
      200-299 % FPL 6,478 13.7 (13.0-14.5)
      ≥ 300% FPL 27,156 52.2 (51.3-53.1)
      Education Level
      < High-school 4,795 16.3 (16.1-16.4)
      High-school graduate 10,345 26.0 (25.8-26.0)
      Some college 12,858 23.7 (23.0-24.5)
      College or more 19,333 34.0 (33.3-34.7)
      Health Insurance
      Currently insured 42,186 82.0 (81.0-82.8)
      Not insured 5,145 18.0 (17.1-19.0)
      General Health
      Excellent/Very Good 24,554 52.0 (51.0-52.8)
      Good 13,588 29.8 (28.4-30.8)
      Fair/Poor 9,189 18.2 (17.4-19.0)
      Body Weight Status
      Underweight 1,051 2.2 (2.0-2.5)
      Normal 19,689 41.3 (40.4-42.3)
      Overweight 16,078 33.7 (32.8-34.5)
      Obese 10,513 22.7 (21.8-23.5)
      Physical Activity
      Sedentary 16,936 34.6 (33.6-35.7)
      Some activity 20,838 43.4 (42.3-44.5)
      Regular activity 9,557 21.8 (21.0-22.7)
      Binge drinking status
      Yes 11,049 31.4 (30.5-32.3)
      No 36,282 68.5 (67.6-69.4)

      Conclusion
      In California, many adults with a first-degree family history of cancer still smoke which places them at higher risk for poor health outcomes. Smokers with a first-degree family history of cancer may be an important target population for smoking cessation interventions.

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