Comparing cancer patients who enroll in a smoking cessation program at a comprehensive cancer center with those who decline enrollment

Background. Despite the availability of smoking interventions for cancer patients, many eligible patients decline enrollment into such programs. We examined reasons patients provide for declining smoking treatment and compared treatment decliners to enrollees. Methods. Eligible cancer patients (N = 231) were offered smoking cessation treatment. During recruitment, demographic, medical (eg, cancer stage), and smoking-related behavioral (eg, readiness to quit) data were collected, and decliners stated a reason for refusal. Patients who enrolled in the cessation program (N = 109) were compared with those who declined (N = 122) in terms of recruitment data, and reasons for declining were compiled. Results. Decliners were significantly more likely to: (1) have head and neck cancer (vs lung cancer), (2) exhibit fewer physical symptoms (eg, shortness of breath), (3) report a lower readiness to quit smoking, (4) indicate no intention to quit smoking, and (5) smoke fewer cigarettes. A preference to quit without professional assistance was the most common reason for declining treatment. Conclusions. Our findings highlight important differences between patients who enroll in a smoking cessation program and those who decline and underscore the need for motivational interventions to facilitate enrollment into smoking interventions for cancer patients.