Continued tobacco use beyond cancer diagnosis in India – A systematic review and meta-analysis

IF 2 Q3 HEALTH POLICY & SERVICES
Vishnu Rajan , Sreelakshmi Muralikrishnan , Bharathnag Nagappa , Yamini Marimuthu , Viji Ramachandran , Aravind Palaniappan
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Abstract

Background

Tobacco use is a leading preventable cause of cancer-related mortality, with significant implications for treatment outcomes and survival. In India, where 28.6 % of adults use tobacco, continued use after cancer diagnosis remains a major public health concern. This systematic review and meta-analysis aimed to estimate the pooled prevalence of continued tobacco use among cancer patients in India.

Methods

We conducted a systematic review and meta-analysis of observational studies reporting on continued tobacco use post-cancer diagnosis in India. A systematic search of PubMed, Scopus, and Google Scholar yielded 20 observational studies. Eligible studies included adult cancer patients (≥18 years) and reported prevalence of smoking, smokeless tobacco, or both after diagnosis. Data extraction and quality appraisal were performed independently by authors. A random-effects model was used to compute pooled prevalence estimates. Heterogeneity and publication bias were assessed using the I² statistic and Egger’s test, respectively.

Results

Twenty studies comprising 75,145 participants were included. The pooled prevalence of continued tobacco use post-diagnosis was 74 % (95 % CI: 59–84 %). Subgroup analysis showed a prevalence of 50 % (95 % CI: 39–62 %) for smoking and 34 % (95 % CI: 26–42 %) for smokeless tobacco. Substantial heterogeneity was observed across studies (I² > 95 %). Evidence of publication bias was present for smoking but not for smokeless tobacco use.

Conclusion

Continued tobacco use among Indian cancer patients is alarmingly high, highlighting the urgent need for tobacco cessation interventions within oncology care.

Policy summary

The high prevalence of continued tobacco use among cancer patients in India underscores the need for national health policy to mandate routine tobacco use screening and cessation support. Integrating cessation services into cancer care can improve treatment outcomes, reduce recurrence, and lower overall healthcare costs in oncology settings.
印度癌症诊断之外的持续烟草使用——一项系统回顾和荟萃分析
烟草使用是癌症相关死亡的主要可预防原因,对治疗结果和生存具有重大影响。在印度,28.6% %的成年人使用烟草,在癌症诊断后继续使用烟草仍然是一个主要的公共卫生问题。本系统综述和荟萃分析旨在估计印度癌症患者持续吸烟的总流行率。方法:我们对印度癌症诊断后继续吸烟的观察性研究进行了系统回顾和荟萃分析。通过对PubMed、Scopus和谷歌Scholar的系统搜索,得出了20项观察性研究。符合条件的研究包括成年癌症患者(≥18岁),并报告了诊断后吸烟、无烟烟草或两者的患病率。数据提取和质量评价由作者独立完成。随机效应模型用于计算汇总的患病率估计值。异质性和发表偏倚分别采用I²统计量和Egger’s检验进行评估。结果共纳入20项研究,75,145名受试者。诊断后继续吸烟的总患病率为74 %(95 % CI: 59-84 %)。亚组分析显示吸烟的患病率为50% %(95 % CI: 39-62 %),无烟烟草的患病率为34% %(95 % CI: 26-42 %)。研究中观察到大量异质性(I²>;95 %)。吸烟方面存在发表偏倚的证据,但无烟烟草使用方面没有。结论:印度癌症患者的持续烟草使用率高得惊人,这凸显了在肿瘤治疗中采取戒烟干预措施的迫切需要。政策概述印度癌症患者持续吸烟的高流行率突出表明,有必要制定国家卫生政策,规定常规烟草使用筛查和戒烟支持。将戒烟服务整合到癌症护理中可以改善治疗结果,减少复发,并降低肿瘤环境中的总体医疗保健成本。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Cancer Policy
Journal of Cancer Policy Medicine-Health Policy
CiteScore
2.40
自引率
7.70%
发文量
47
审稿时长
65 days
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