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Lucy Finkelstein-Fox, PhD




Assistant Professor


Massachusetts General Hospital




Lucy Finkelstein-Fox, JoRean Sicks, Elyse Park, Jamie S. Ostroff, Isabelle Miranda, Rachel L. Rosen, Maria Lopes, Brett M. Goshe, Ilana F. Gareen, Benjamin A. Herman, Alex Taurone, Angela W. Walter, Susan Regan, Autumn Rasmussen, Douglas Levy, Alona Muzikansky, Michelle Lui, Michael Alan Thompson, Ruth C. Carlos, Lynne I. Wagner on behalf of the EA171CD study team

Principal Investigator


Gender Differences in Communication About Smoking Cessation For Recently-Diagnosed Cancer Patients (ECOG-ACRIN EAQ171CD)


Smoking is an important, modifiable health risk for cancer patients, making it essential that oncology clinicians provide cessation support to their patients. Gender differences in communication about smoking remain unexplored. We investigated this issue among 306 recently-diagnosed cancer patients.

Patient participants from 30 sub-affiliate community and 7 minority/underserved NCORP practices (70.9% Female; 86.2% White; Median age = 57.5; 44.8% smoking-related tumors) provided baseline data from a trial of smoking cessation counseling and medication. Patient surveys included assessments of smoking heaviness (range: 0-6), readiness to quit (range: 0-9), and smoking-related communication with their oncology clinician (yes/no). Gender comparisons are presented as proportions with [95% confidence intervals] of the difference (CId) for dichotomous characteristics and median with (interquartile ranges) for continuous characteristics.

Male and female participants reported high smoking heaviness (median = 3 (2, 4) and median = 3 (2, 3), respectively) and readiness to quit (median = 7 (5, 9); and median = 8 (5, 9), respectively). 95.4% of males and 93.3% of females were asked about their interest in quitting; 95% CId [-3.6%, 7.5%]) and 90.8% of men and 90.0% of women were advised to quit (95% CId [-6.3%, 8.3%]). Many men (50.6%) and women (58.6%) received praise for attempting to quit (95% CId [-20.2%, 4.6%]). Clinicians commonly discussed how to quit (86.2% of men, 69.2% of women; 95% CId [7.5%, 26.6%]), recommended counseling (62.1% of men, 47.1% of women; 95% CId [2.9%, 27.3%]), suggested a follow-up call/visit (41.4% of men, 28.2% of women; 95% CId [1.2%, 25.1%]), and recommended cessation medications (72.4% of men; 65.2% of women; 95% CId [-4.7%, 18.0%]).

Although not powered for gender comparisons, this study indicates that males and females were similarly advised to quit smoking while a greater proportion of males were offered any quitting assistance. These results have implications for women’s health equity.

Research Context

Previous literature suggests that women with a history of smoking cigarettes are less likely to maintain long-term smoking abstinence when compared to men, though women and men similarly express desire to quit. As such, women may be at increased risk for deleterious health effects of smoking; such risks are pronounced during cancer treatment, when quitting is essential for cancer treatment effectiveness and recovery. To identify possible targets of public health intervention, the present analysis explored gender differences in patient-clinician communication about smoking cessation among a large sample of recently-diagnosed cancer patients who smoke. Results have important implications for women’s health equity in cancer care, highlighting patient-clinician communication about specific instrumental resources for smoking cessation as a potential social factor shaping women’s health outcomes.