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Associations between Smoking, Opioid Analgesic Use, and Risk For Chemical Coping in Korean Patients with Advanced
Eun Hee Jung1,2, Yu Jung Kim1,2, Rony Dev3
1Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Cancer Research and Treatment
|February 5, 2026
Summary
Current smokers with advanced cancer in Korea showed higher opioid doses and increased risk of chemical coping. Monitoring substance use and coping strategies is crucial for this patient group.
Area of Science:
- Oncology
- Addiction Medicine
- Public Health
Background:
- Smoking is prevalent in patients with advanced cancer.
- Understanding substance use behaviors is vital for managing cancer pain and treatment.
- Korean cancer patients present unique demographic and clinical profiles.
Purpose of the Study:
- To investigate the associations between smoking, pain, opioid use, substance use, coping strategies, and chemical coping risk.
- To identify specific risk factors for chemical coping in advanced cancer patients.
- To inform clinical practice regarding substance use in this population.
Main Methods:
- Prospective study of 240 Korean patients with advanced cancer.
- Data collected via medical records, questionnaires, and interviews.
- Assessed smoking status, symptom burden (ESAS), alcoholism (CAGE), opioid dose (MEDD), coffee/tranquilizer use, coping strategies, and chemical coping risk.
Main Results:
- Current smokers (20.4%) had significantly higher morphine equivalent daily dose (MEDD) and were more likely to be CAGE-positive and heavy coffee drinkers.
- Physician-assessed risk of chemical coping was higher in current smokers (26.5%) compared to former (8.7%) and never-smokers (13.8%).
- Smoking status was strongly associated with male gender, while women were more likely to be never-smokers.
Conclusions:
- Current smokers with advanced cancer in Korea exhibit higher opioid use and increased risk for chemical coping.
- Positive CAGE results and heavy coffee consumption are more prevalent in current smokers.
- Close monitoring for chemical coping and non-medical opioid use is essential in this patient group.
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