Physician Support of Smoking Cessation After Diagnosis of Lung, Bladder, or Upper Aerodigestive Tract Cancer

Amanda Farley, Constantinos Koshiaris, Jason Oke, Ronan Ryan, Lisa Szatkowski, Richard Stevens, Paul Aveyard

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Purpose: Smoking cessation after diagnosis of lung, bladder, and upper aerodigestive tract cancer appears to improve survival and support to quit would improve cessation. The aims of this study were to assess how often general practitioners (GPs) provide active cessation support in these patients and whether this is influenced by incentive payments.

Methods: Using electronic primary care records from the UK Clinical Practice Research Datalink (CPRD), 12,393 incident cancer cases diagnosed between 1999-2013 were matched 1:1 with incident coronary heart disease (CHD) patients. We assessed differences in the proportion whose GPs updated smoking status, advised quitting, prescribed cessation medications, or stopped smoking within a year of diagnosis and whether any differences arose because GPs were incentivised to address smoking in patients with CHD and not cancer.

Results: At diagnosis, 32·0% of patients with cancer and 18·2% of patients with CHD smoked. Patients with cancer were less likely than patients with CHD to have GPs update smoking status (OR 0·18 (95%CI 0·17-0·19)), advise quitting (OR 0·38 (95%CI 0·36-0·40)), prescribe medication (OR 0·67 (95%CI 0·63-0·73)), or stop smoking (OR 0·76 (95%CI 0·69-0·84)). 61.7% of people with cancer and 55·4% with CHD who smoked at diagnosis were smoking one year later. Introducing incentives was associated with more frequent intervention but not for CHD patients specifically.

Conclusions: General practitioners are less likely to support smoking cessation in patients with cancer than CHD and patients with cancer are less likely to stop smoking, and this is not due to the difference in incentive payments.
Original languageEnglish
Article number15
Pages (from-to)443-450
JournalAnnals of family medicine
Issue number5
Publication statusPublished - 1 Sept 2017


  • cancer
  • primary care
  • smoking
  • smoking cessation


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