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。虽然存活率的提高突出了医疗干预的非凡成就，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经历后续健康并发症的风险增加。当决定是否从事吸烟等不健康行为时，幸存者应该将他们的医疗脆弱性纳入决策中。然而，研究表明，儿童癌症幸存者经常以与健康同龄人相似的速度从事不健康的行为，尽管对器官毒性的脆弱性增加。因此，需要采取干预措施，帮助幸存者就其健康行为做出明智、健康的决定，以延长其无病状态。吸烟是干预的一个重要重点，因为吸烟与健康问题之间存在已知的联系。为了为预防工作提供信息，有必要更好地了解影响幸存者吸烟决定的因素，并在幸存者独特的医疗背景下考虑这些因素。该提案的目的是：1）评估儿童癌症青少年幸存者的烟草使用率，2）确定与该人群中烟草使用相关的风险因素，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，以指导未来更大规模的调查和预防工作。这一研究建议符合NIDA的研究重点“理解......社会背景在决策和冒险行为中的作用”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率的背景下研究吸烟，但研究结果可能会阐明与儿童其他疾病相关的吸烟风险因素（例如，哮喘、糖尿病）。这项研究旨在提供有关风险的重要信息，以便为以后的干预措施提供信息。

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.