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      High‐risk older smokers' perceptions, attitudes, and beliefs about lung cancer screening

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          Abstract

          The US Preventive Services Task Force recommends that smokers aged 55–80 should be screened annually with low‐dose computed tomography ( LDCT). This study identified demographics, smoking history, health risk perceptions, knowledge, and attitudes factors of older smokers (≥55 years) related to LDCT agreement. Using binary logistic regression, a predictive model of factors to explain LDCT agreement was produced. This is a cross‐sectional, national, online survey of 338 older smokers (≥55 years) with a ≥30 pack‐year smoking history. Over 82% of the sample believed that a person who continues to smoke after the age of 40 has at least a 25% chance of developing lung cancer and 77.3% would “agree to a LDCT today”. Using chi‐square analyses, six variables that were significant at the 0.10 level were selected for inclusion in model development. Four of the independent variables made a unique statistically significant contribution to the model: perceives accuracy of the LDCT as an important factor in the decision to have a LDCT scan; believes that early detection of LC will result in a good prognosis; believes that they are at high risk for lung cancer; and is not afraid of CT scans. Of note, only 10.9% believed that a negative CT scan result would mean that they could continue to smoke. Older smokers are aware of the risks of smoking, are interested in smoking cessation, and most are interested in and positive about LDCT. Cognitive aspects of participation in screening are key to increasing the uptake of lung cancer screening among high‐risk smokers.

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          Quitting motives and barriers among older smokers. The 1986 Adult Use of Tobacco Survey revisited.

          Adults aged 50-74 years comprise more than 20% of the population and more than 22% of all smokers. Smoking is a risk factor for 7 of the 14 major causes of death for older adults, including cancer, heart disease, and lung disease. Moreover, older smokers can experience significant dramatic health benefits from quitting, including improvements in circulation and pulmonary function and declines in risks for heart disease, heart attacks, and stroke. Smoking patterns, quitting motives, and barriers among older smokers were examined by comparing responses of older smokers (aged 50-74 years) and younger smokers (aged 21-49 years) who took part in the 1986 Adult Use of Tobacco Survey. Older and younger smokers differed little in current smoking patterns or in past quit attempts, motives, and methods. Survey results show that older smokers are far less likely to accept smoking health harms and more likely to view smoking as a beneficial coping and weight control tactic. Motivational strategies should be tailored to the unique health beliefs and cultural history of older smokers.
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            Attitudes and beliefs toward lung cancer screening among US Veterans.

            Lung cancer (LC) is the leading cause of cancer-related death for veterans cared for by the US Veterans Health Administration. The LC burden among veterans is almost double that of the general population. Before implementation of an LC screening program, we set out to assess the role of beliefs and attitudes toward LC screening among veterans.
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              The disproportionate cost of smoking for African Americans in California.

              We estimated the economic impact of smoking on African Americans in California in 2002, including smoking-attributable health care expenditures and productivity losses from smoking-caused mortality. We estimated econometric models of smoking-attributable ambulatory care, prescription drugs, inpatient care, and home health care using national and state survey data. We assessed smoking-attributable mortality using epidemiological models. Adult smoking prevalence for African Americans was 19.3% compared with 15.4% for all Californians. The health care cost of smoking was $626 million for the African American community. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity. The total cost of smoking for this community amounted to $1.4 billion, or $1.8 billion expressed in 2008 dollars. Although African Americans account for 6% of the California adult population, they account for over 8% of smoking-attributable expenditures and fully 13% of smoking-attributable mortality costs. Our findings confirm the need to tailor tobacco control programs to African Americans to mitigate the disproportionate burden of smoking for this community.
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                Author and article information

                Journal
                Cancer Med
                Cancer Med
                10.1002/(ISSN)2045-7634
                CAM4
                Cancer Medicine
                John Wiley and Sons Inc. (Hoboken )
                2045-7634
                28 January 2016
                April 2016
                : 5
                : 4 ( doiID: 10.1002/cam4.2016.5.issue-4 )
                : 753-759
                Affiliations
                [ 1 ]University of California San Francisco California
                [ 2 ]UCSF Center for Tobacco Control Research and Education San Francisco California
                Author notes
                [*] [* ] Correspondence

                Janine K. Cataldo, 2 Koret Way, Room N611Q, San Francisco, CA 94143‐0610, USA. Tel: 415/476 4721; Fax: 415/476 8899; E‐mail: janine.cataldo@ 123456ucsf.edu

                Article
                CAM4617
                10.1002/cam4.617
                4831294
                26822940
                b4b97734-91f2-4fd2-b4d2-e3ec06e9addc
                © 2016 The Author. Cancer Medicine published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 July 2015
                : 22 November 2015
                : 23 November 2015
                Page count
                Pages: 7
                Funding
                Funded by: National Cancer Institute and Food and Drug Administration Center for Tobacco Products
                Award ID: 1P50CA180890
                Funded by: UCSF
                Categories
                Original Research
                Cancer Prevention
                Original Research
                Custom metadata
                2.0
                cam4617
                April 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.8.6 mode:remove_FC converted:09.04.2016

                Oncology & Radiotherapy
                attitude to health,early detection of cancer/psychology,health status,lung neoplasms/diagnosis,older smokers,questionnaires,smoking/adverse effects

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