Smoking among Survivors of Childhood Cancer

描述（由候选人提供）：儿童癌症治疗和治愈的进步导致幸存者人数不断增加。虽然不断提高的存活率突出了医疗干预取得的非凡成就，但绝不能低估疾病和治疗的持久后果。儿童癌症幸存者在一系列器官系统中出现后续健康并发症的风险增加。当决定是否从事不健康的行为，如吸烟，幸存者应该考虑到他们的医疗脆弱性在他们的决策。然而，研究表明，儿童癌症幸存者的不健康行为率与健康同龄人相似，尽管他们更容易受到器官毒性的影响。因此，需要采取干预措施，帮助幸存者对其健康行为作出知情、健康的决定，努力延长其无病状态。鉴于吸烟与健康问题之间的已知联系，吸烟是干预的一个重要重点。为了为预防工作提供信息，有必要更好地了解哪些因素影响幸存者对吸烟的决定，并在幸存者独特的医疗背景下考虑这些因素。本提案的目标是：1)评估儿童癌症青少年幸存者中烟草使用的流行程度，2)确定该人群中与烟草使用相关的风险因素，以及3)确定某些幸存者群体在决定使用烟草时是否更容易受到外部影响。这项研究将描述与青少年幸存者烟草使用相关的生物、心理和社会变量，以便指导未来更大规模的调查和预防工作。这项研究计划符合NIDA的研究重点，即“理解……社会背景在决策和冒险行为中起作用”和“了解药物成瘾在医疗疾病过程中的负担”（http://www.drugabuse.gov/StrategicPlan/lndex.html）。虽然这项调查将在儿童癌症存活的背景下检查吸烟，但调查结果可能阐明与其他儿童疾病（如哮喘、糖尿病）相关的吸烟风险因素。本研究旨在提供有关风险的重要信息，以便为以后的干预提供信息。

DESCRIPTION (provided by candidate): Advancements in the treatment and cure of childhood cancer have resulted in a growing population of survivors. While increasing survival rates highlight exceptional triumphs in medical intervention, the lasting consequences of disease and treatment must not be underestimated. Pediatric cancer survivors experience an increased risk of subsequent health complications across a range of organ systems. When deciding whether to engage in unhealthy behaviors, such as smoking, survivors should factor their medical vulnerability into their decision-making. However, research has demonstrated that pediatric cancer survivors often engage in unhealthy behaviors at rates similar to their healthy peers, despite having an increased vulnerability to organ toxicity. Thus, interventions are needed to assist survivors in making informed, healthy decisions about their health behaviors in an effort to prolong their disease-free status. Smoking is an important focus for intervention, given the known connections between smoking and problematic health consequences. In order to inform prevention efforts, it is necessary to better understand what factors influence survivors in their decisions about smoking and to consider these factors within the context of survivors' unique medical context. The objectives of this proposal are: 1) to assess the prevalence of tobacco use in adolescent survivors of pediatric cancer, 2) to determine risk factors associated with tobacco use in this population, and 3) to ascertain if certain groups of survivors are more vulnerable to external influences when deciding to use tobacco. This research will describe biological, psychological, and social variables that are associated with tobacco use in adolescent survivors in order to direct larger investigations and prevention efforts in the future. This research proposal is in keeping with NIDA's research priorities of "understanding the role that...social context play[s] in decision-making and risk taking behaviors" and "understanding the burden of drug addiction in the course of medical illness" (http://www.drugabuse.gov/StrategicPlan/lndex.html). While this investigation will examine smoking within the context of childhood cancer survivorship, findings may illuminate risk factors for smoking that are relevant to other diseases of childhood (e.g., asthma, diabetes). This study is intended to provide important information about risks in order to inform later interventions.