Reflecting on Tobacco and Alcohol Use Impact on Mental Health in Lung Cancer Patient-Caregiver Dyads
Abstract
Lung cancer (LC), a leading cause of morbidity and mortality, imposes significant burdens not only on patients but also on their caregivers,1,2,3,4 creating a unique dynamic within patient-caregiver (LC-PG) dyads. Tobacco and alcohol use, which are associated with both the development and exacerbation of anxiety and depressive symptoms, present critical individual-level factors that require further investigation, particularly given the potential for reverse causality.5,6,7
The purpose of this study was to determine the concordance and predictive association between alcohol and tobacco use and anxiety and depressive symptoms among LC-SC dyads using the actor-partner interdependence model (APIM).
Method: LC patients and their primary caregivers self-reported their current tobacco and alcohol use and completed the anxiety and depressive symptoms questionnaire using the Patient-Reported Outcomes Measurement Information System (PROMIS™). Data were analyzed using the SAS program. Descriptive statistics were used to describe the sample characteristics. Cohen's Kappa and Spearmen correlation were used to assess concordance. The APIM was applied using complete case analyses to determine the association between tobacco and alcohol use and anxiety and depressive symptoms among LC-SG dyads.
Results: A total of 48 LC-PG dyads were included in the analysis. Around 22% and 6% of the LC-PG dyads were current tobacco and alcohol users, respectively. The analysis revealed significant concordance in tobacco (k=.53,p=.003) but not alcohol (k=.25) use, anxiety (r=.15) or depression (r=.19,p=.12). In the actor model, suggestive trends included LC patients’ tobacco use that was associated with their anxiety (β=8.35,p=.05) and depressive symptoms (β=7.81,p=.08). However, alcohol use was not associated with anxiety or depressive symptoms among LC patients or their caregivers. In the partner model, we found suggestive trends of survivors’ tobacco and alcohol use on caregiver anxiety (β=-5.8, β=5.8) and depression (β=-8.1, β=2.4). We found no effect of caregivers’ tobacco use on survivor anxiety or depression scores.
Conclusion: The results of this study indicate a notable concordance in tobacco, alcohol use, and depression, suggesting that the behaviors and mental health of one partner can influence the other. Study limitations include a small sample size in addition to missing data that may have produced insufficient power to detect significant effects.
Notes
References:
1- American Cancer Society. Facts & Figures 2023. American Cancer Society. Atlanta, Ga. 2023.
https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html
2- Geng HM, Chuang DM, Yang F, Yang Y, Liu WM, Liu LH, Tian HM. Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Sep;97(39):e11863. doi: 10.1097/MD.0000000000011863. PMID: 30278483; PMCID: PMC6181540.
3- Lippiett, K. A., Richardson, A., Myall, M., Cummings, A., & May, C. R. (2019). Patients and informal caregivers’ experiences of burden of treatment in lung cancer and chronic obstructive pulmonary disease (COPD): a systematic review and synthesis of qualitative research. BMJ open, 9(2), e020515.
4- Leiter, A., Veluswamy, R. R., & Wisnivesky, J. P. (2023). The global burden of lung cancer: current status and future trends. Nature reviews Clinical oncology, 20(9), 624-639.
5-Geng HM, Chuang DM, Yang F, Yang Y, Liu WM, Liu LH, Tian HM (2018). Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine (Baltimore). 97(39):e11863. doi: 10.1097/MD.0000000000011863. PMID: 30278483; PMCID: PMC6181540.
6- Brenner, Darren R. et al. (2019) Alcohol Consumption and Lung Cancer Risk: A Pooled Analysis from the International Lung Cancer Consortium and the SYNERGY Study. Cancer epidemiology 58 (2019): 25–32. Web.
7- Riedl, D., & Schüßler, G. (2022). Factors associated with and risk factors for depression in cancer patients–A systematic literature review. Translational oncology, 16, 101328.
Sigma Membership
Delta Psi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Health Equity or Social Determinants of Health, Policy and Advocacy, Public and Community Health, Promoting Clinical Outcomes, Lung Cancer, Anxiety and Depression, Patients and Caregivers
Recommended Citation
Abufarsakh, Bassema and Okoli, Chizimuzo T. C., "Reflecting on Tobacco and Alcohol Use Impact on Mental Health in Lung Cancer Patient-Caregiver Dyads" (2025). Biennial Convention (CONV). 217.
https://www.sigmarepository.org/convention/2025/presentations_2025/217
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-12-08
Funder(s)
Bristol Myers Squibb Foundation
Reflecting on Tobacco and Alcohol Use Impact on Mental Health in Lung Cancer Patient-Caregiver Dyads
Indianapolis, Indiana, USA
Lung cancer (LC), a leading cause of morbidity and mortality, imposes significant burdens not only on patients but also on their caregivers,1,2,3,4 creating a unique dynamic within patient-caregiver (LC-PG) dyads. Tobacco and alcohol use, which are associated with both the development and exacerbation of anxiety and depressive symptoms, present critical individual-level factors that require further investigation, particularly given the potential for reverse causality.5,6,7
The purpose of this study was to determine the concordance and predictive association between alcohol and tobacco use and anxiety and depressive symptoms among LC-SC dyads using the actor-partner interdependence model (APIM).
Method: LC patients and their primary caregivers self-reported their current tobacco and alcohol use and completed the anxiety and depressive symptoms questionnaire using the Patient-Reported Outcomes Measurement Information System (PROMIS™). Data were analyzed using the SAS program. Descriptive statistics were used to describe the sample characteristics. Cohen's Kappa and Spearmen correlation were used to assess concordance. The APIM was applied using complete case analyses to determine the association between tobacco and alcohol use and anxiety and depressive symptoms among LC-SG dyads.
Results: A total of 48 LC-PG dyads were included in the analysis. Around 22% and 6% of the LC-PG dyads were current tobacco and alcohol users, respectively. The analysis revealed significant concordance in tobacco (k=.53,p=.003) but not alcohol (k=.25) use, anxiety (r=.15) or depression (r=.19,p=.12). In the actor model, suggestive trends included LC patients’ tobacco use that was associated with their anxiety (β=8.35,p=.05) and depressive symptoms (β=7.81,p=.08). However, alcohol use was not associated with anxiety or depressive symptoms among LC patients or their caregivers. In the partner model, we found suggestive trends of survivors’ tobacco and alcohol use on caregiver anxiety (β=-5.8, β=5.8) and depression (β=-8.1, β=2.4). We found no effect of caregivers’ tobacco use on survivor anxiety or depression scores.
Conclusion: The results of this study indicate a notable concordance in tobacco, alcohol use, and depression, suggesting that the behaviors and mental health of one partner can influence the other. Study limitations include a small sample size in addition to missing data that may have produced insufficient power to detect significant effects.
Description
This study examined the relationship between tobacco and alcohol use and anxiety and depressive symptoms in lung cancer patient-caregiver dyads. The results of this study indicate a notable concordance in tobacco, alcohol use, and depression, suggesting that the behaviors and mental health of one partner can influence the other. Nurses play a vital role as they reflect on dyadic needs and respond with tailored interventions to improve mental health and well-being.