Author ORCID Identifier

https://orcid.org/0000-0003-0730-3090

Date Available

1-10-2025

Year of Publication

2025

Document Type

Master's Thesis

Degree Name

Master of Science (MS)

College

Arts and Sciences

Department/School/Program

Psychology

Advisor

Dr. Jessica L. Burris

Abstract

Smoking after cancer diagnosis is associated with poor outcomes while smoking cessation can improve quality of life and promote survival. Although there are calls for equitable tobacco treatment delivery in cancer and other healthcare settings, disparities in tobacco-related disease burden persist. In the context of an outpatient cancer center’s population-based tobacco treatment program, this study examines the association between cancer survivors’ rural and Appalachian residence and 1) current tobacco use status, 2) decision to decline cessation assistance, and 3) reason for declining assistance. A cross-sectional, retrospective analysis was conducted using electronic health record data from 16,839 adults (64.04% female, 88.49% non-Hispanic white, 59.19±14.52 years old) who sought cancer care in 2019. Descriptive statistics and logistic regression models were applied. Rural participants had higher odds of tobacco use than urban ones (OR = 1.22; 95% CI, 1.12–1.34), as did Appalachian residents compared to non-Appalachians (OR = 1.41; 95% CI, 1.28–1.54). Neither rural nor Appalachian status was significantly associated with responses to cessation assistance offers or reason for declining. Findings highlight continued need for population-level tobacco use screening and proactive cessation assistance offers, given elevated tobacco use in some minority groups and overall low rates of evidence-based tobacco treatment acceptance.

Digital Object Identifier (DOI)

https://doi.org/10.13023/etd.2024.538

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