Insights into smoking cessation support for lung cancer patients: A multi-site survey of patient perspectives post-diagnosis

Background: Although extensive research demonstrates that quitting smoking after a cancer diagnosis-regardless of stage-improves treatment outcomes and quality of life, 30% of patients continue smoking. This study explored differences between lung cancer patients who smoke post-diagnosis and the general smoker population and examined the gap between evidence and patient perspectives by surveying perceived benefits, barriers, and views on cessation support across two community oncology sites in Connecticut. Methods: We conducted a cross-sectional survey at two clinical sites, recruiting participants during routine visits. The survey assessed demographics, smoking history, perceived benefits and barriers, prior cessation resource effectiveness, comfort and priorities for clinician discussion, concerns about stigma or financial influence, and knowledge and confidence. Most items used 5-point Likert scales and were summarized descriptively. Items were dichotomized (1-3 vs. 4-5) per prespecified rules; items where “1” indicated highest importance/challenge were inverted for consistency. Data was managed in REDCap. Results: Sample: N=40; age 68.1±6.9; 55.0% female; 40.4±11.6 years smoking; 13.3±8.7 cigarettes/day; 27.9±22.4 pack-years. Only 7.5% rated current cessation resources as effective. While 55% felt comfortable discussing cessation, 35% wanted more frequent discussions, and 32.5% wanted oncology teams to address cessation even without explicit survival framing. Concerns included fear that disclosure could affect treatment/resources (37.5%) and finances (27.5%). Knowledge and confidence were moderate (67.5% felt informed and confident). Top internal barriers were withdrawal (52.5%) and reliance on smoking for stress relief (42.5%); external barriers were less common (17.5% lacked knowledge of resources; 17.5% felt rushed/unsupported). Leading motivators: preventing other smoking-related diseases (80%), improving cancer treatment effectiveness (75%), and enhancing daily comfort (62.5%). Additional drivers included a sense of control (40%) and being a role model (42.5%). Percentages reflect item-level endorsement (agree/strongly agree); totals do not sum to 100% because multiple selections were allowed. Conclusions: Patients reported reasonable knowledge and confidence but low perceived effectiveness of current resources, with many desiring more frequent, nonjudgmental discussions. Stigma and fear of negative consequences may suppress disclosure, limiting support. Internal barriers-especially withdrawal and stress coping-predominated. Future implementation priorities include routine, stigma-aware oncology conversations emphasizing ongoing benefits of quitting; proactive withdrawal management with evidence-based pharmacotherapy; and clear messaging to reduce disclosure fears and foster engagement.