Editor,—We examined the smoking cessation rate among outpatients two months after their first visit to Aichi Cancer Center Hospital, where no programmed cessation support for smokers was provided. Subjects were first-visit outpatients who participated in a lifestyle questionnaire survey, HERPACC (Hospital-based Epidemiologic Research Program at Aichi Cancer Center)¹ between 16 September 1997 and 11 September 1998. HERPACC identified 1304 smokers, of whom 1131 (86.7%) agreed to participate in the follow-up study. A brief questionnaire including questions on disease diagnosed (“cancer”, “non-cancerous disease”, “no disease”, or “under examination”) and smoking behaviour, was sent to the participants two months after the completion of the first questionnaire. Two participants had died and the addresses for five participants were incorrect, resulting in 1124 eligible participants (755 males and 369 females). Those aged under 40 years were 16.2% (males) and 40.7% (females).

The response rates at follow-up were 62.1% (males) and 47.4% (females). Among respondents, 201 males and 31 females had been diagnosed as having cancer. Those answering that they had quit smoking were 77.1% (95% confidence interval (CI) = 71.3 to 82.9) in the male patients with cancer and 58.1% (95%CI = 40.7 to 75.5) in the female patients with cancer. The difference in the abstinence rate between male and female respondents was statistically significant (p<0.05). Odds ratios of smoking cessation for sex, age, and diagnosis were calculated by a multivariate unconditional logistic model (table). In the analysis for 644 respondents, sex and diagnosis were found to be significant factors predicting smoking cessation. The estimated odds ratio for females was about half that of males. In comparison with participants without disease, the odds ratio of cessation for those diagnosed with cancer was markedly large (OR = 27.5). The estimate was 2.90 for participants with a non-cancerous disease , and 2.98 for participants still under examination.

Visiting a hospital as a patient or becoming ill provides smokers with a good opportunity to consider smoking cessation. It has been reported that most patients with serious diseases, such as myocardial infarction,2 3 quit smoking with or without cessation support. We obtained a similar finding for patients with cancer in Japan. Of interest is that female patients were less likely to quit smoking than male patients, although the number of female smokers with cancer was limited. The cessation rate observed in this study is higher than that in other situations. Smokers attending hospital are sensitive to advice and good targets for cessation programmes.