R01CA258269

Longitudinal Mixed Method Investigation of Social Networks and Affective States as Determinants of Smoking Behavior Among Cancer Patients - Project Summary

Tobacco use causes at least 12 types of cancer and is responsible for 30% of all cancer deaths in the United States. Quitting smoking is the single most effective approach to protect cancer patients from smoking complications, extend survival, and ensure the best health outcomes. Despite the adverse health effects, 10-64% of cancer patients, depending on cancer type, continue to smoke. Cancer diagnosis is an emotionally shocking experience, and patients often use tobacco to regulate negative emotions. Smoking rates are the highest among patients with tobacco-related cancers who have a long smoking history, high nicotine addiction, and difficulty with quitting smoking. Even after quitting, they relapse as discontinuation of tobacco leads to negative emotions, which in turn impacts smoking behavior.

Smoking behavior is embedded within an individual's affective niche and social networks and is influenced by the behaviors of individuals in the network. Yet, to date, no attention has been paid to how social networks and affective states influence smoking behavior of patients with tobacco-related cancer who have high rates of smoking, nicotine dependency, negative emotions, and struggle with quitting smoking, nor how patients' cancer diagnosis affects smoking behavior of their network members. Our mixed methods study will fill this gap in the evidence.

We will achieve these four specific aims:

AIM 1: Determine tobacco-related cancer patients' affective states, social network structures (e.g., connected to other smokers), and functions (e.g., interaction type—emotional support) and identify clusters of current-, former-, and non-smokers within those networks.

AIM 2: Quantify the influence of tobacco-related cancer patients' affective states, social network structures and functions, and network members' attributes (e.g., sex, smoking behavior, etc.) on patients' smoking behavior.

AIM 3: Assess the impact of a patient's tobacco-related cancer diagnosis on the smoking behavior of the patient's network members (i.e., five to ten individuals the patient identifies as close social contacts).

AIM 4: Explore the facilitators and barriers (e.g., affective states, encouragement to quit smoking) to smoking cessation in patients with tobacco-related cancer and their significant network member dyads.

Using a prospective longitudinal design with an egocentric social network, we will collect data from newly diagnosed patients with tobacco-related cancer from a world-renowned cancer center, Dana-Farber Cancer Institute. Data from 429 patients will be collected at baseline (within 3 months of diagnosis) and then 3-, 6-, and 12-months later. We will also conduct semi-structured dyadic relationship-based qualitative interviews with a cancer patient and a self-identified significant network member to explore the depth and complexity of smoking behaviors.

Our study is crucial as it will address the critical importance of affective states and social networks in smoking behavior, and findings will lay the groundwork for developing and testing novel, tailored, social network-based smoking cessation interventions to better promote smoking cessation among tobacco-related cancer patients and their social network members—families, friends, and others.

Yale Univ

TO IDENTIFY CANCER RISKS AND RISK REDUCTION STRATEGIES, TO IDENTIFY FACTORS THAT CAUSE CANCER IN HUMANS, AND TO DISCOVER AND DEVELOP MECHANISMS FOR CANCER PREVENTION AND PREVENTIVE INTERVENTIONS IN HUMANS. RESEARCH PROGRAMS INCLUDE: (1) CHEMICAL, PHYSICAL AND MOLECULAR CARCINOGENESIS, (2) SCREENING, EARLY DETECTION AND RISK ASSESSMENT, INCLUDING BIOMARKER DISCOVERY, DEVELOPMENT AND VALIDATION, (3) EPIDEMIOLOGY, (4) NUTRITION AND BIOACTIVE FOOD COMPONENTS, (5) IMMUNOLOGY AND VACCINES, (6) FIELD STUDIES AND STATISTICS, (7) CANCER CHEMOPREVENTION AND INTERCEPTION, (8) PRE-CLINICAL AND CLINICAL AGENT DEVELOPMENT, (9) ORGAN SITE STUDIES AND CLINICAL TRIALS, (10) HEALTH-RELATED QUALITY OF LIFE AND PATIENT-CENTERED OUTCOMES, AND (11) SUPPORTIVE CARE AND MANAGEMENT OF SYMPTOMS AND TOXICITIES. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO STIMULATE TECHNICAL INNOVATION, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE RESEARCH AND DEVELOPMENT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING, AND FOSTER PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY WOMEN AND SOCIALLY/ECONOMICALLY DISADVANTAGED PERSONS.

93.393 - Cancer Cause and Prevention Research

National Cancer Institute (NCI) [HHS - NIH]

Orange, Connecticut 064773646 United States

Single Zip Code

Fundamental Mechanisms of Affective and Decisional Processes in Cancer Control (R01 Clinical Trial Optional) (PAR-20-034)

Amendment Since initial award the total obligations have increased 391% from $638,089 to $3,134,858.