Fear and Health Behavior: The Association Between Fear of Cancer Recurrence and Smoking Cessation

To evaluate the impact of fear of cancer recurrence (FCR) on smoking cessation in patients diagnosed with bladder tumors. This study explores its potential role as a motivator for behavioral changes, specifically tobacco abstinence.

A total of 79 patients undergoing surgical intervention for tumor treatment were included in this cross-sectional study. Smoking history and the specific motivation for cessation were documented. FCR was assessed using the Fear of Cancer Recurrence Inventory - Short Form (FCRI-SF). Statistical analysis was performed to compare FCRI-SF scores between patients who achieved smoking cessation due to their diagnosis and those who did not.

The median age of the cohort was 55.4 years (IQR 48.0-65.5). Among the 35 patients (44.3%) with a smoking history, 12 (34.3%) successfully achieved smoking cessation specifically attributed to their tumor diagnosis. These patients reported significantly higher FCRI-SF scores (M = 24.08, SD = 4.01) compared to the non-cessation group (M = 13.04, SD = 7.75; P <.001). Notably, 100% of the patients who quit smoking reached the clinical threshold for FCR (≥13), compared to only 43.5% of those who continued smoking. High frequency of intrusive thoughts and elevated perceived risk of recurrence were the most significant drivers for those who quit.

Higher levels of FCR are strongly associated with successful smoking cessation following a tumor diagnosis. Our findings suggest that clinical FCR may serve as a critical "teachable moment" for health behavior modification. Integrating smoking cessation programs into the psychological management of patients with high FCR could enhance long-term oncology outcomes.