Takeaway
- More than 90% of study patients with lung cancer who used tobacco in the year preceding their diagnosis also had tobacco use disorder (TUD); most cases were severe.
Why this matters
- Criteria for TUD changed significantly between the DSM-IV and DSM-V.
- The International Association for the Study of Lung Cancer recently issued a declaration advising physicians to screen patients for tobacco use and advise cessation.
Study design
- 200 patients with lung cancer who used tobacco within the year preceding diagnosis.
- Funding: National Health Insurance Services, Republic of Korea.
Key results
- 78.5% were diagnosed with nicotine dependence under DSM-IV criteria, 27.5% severe.
- 92.0% were diagnosed with TUD under DSM-V criteria, 63.0% severe.
- 73.0% had attempted quitting, 41.5% more than once.
- 42.5% successfully quit within 3 months, and 30.5% in ≥3 months.
- 30.0% had undergone smoking cessation treatment, including counseling, nicotine replacement therapy, and/or pharmacotherapy.
- Patients with severe vs moderate TUD were less likely to have tried to quit >3 times (21.4% vs 63.2%; P=.009).
- The number of satisfied DSM-V TUD criteria was associated with cumulative lifetime smoking amount (P=.001), cigarettes/day (P=.032), and Fagerstrom test for nicotine dependence score (P=.001).
Limitations
- Smoking amounts were self-reported.
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