Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Rashelle B. Hayes

Second Advisor

Bruce Rybarczyk


Cancer survivors who use tobacco are at a greater risk of death and poor health outcomes. Although tobacco use during cancer survivorship is associated with poor psychosocial functioning, it is relatively unknown how tobacco use is associated with other variables important to cancer survivorship, such as family functioning and posttraumatic growth. Thus, the current study aims to contribute to this gap within the literature by investigating the association between family conflict, posttraumatic growth, and current tobacco use status among cancer survivors. Participants were recruited from Virginia Commonwealth University’s Massey Comprehensive Cancer Center and eligible to participate if they received any cancer diagnosis and had used tobacco within 180 days of diagnosis. Of the 8,563 potentially eligible patients, 174 enrolled into the cross-sectional survey study. Logistic regression analyses showed that family conflict and family dysfunction were significantly associated with current tobacco use status, although these associations did not remain in adjusted models. Posttraumatic growth was not significantly associated with current tobacco use status. Exploratory analyses demonstrated that financial security significantly moderated the association between family conflict and current tobacco use status. Other significant correlates of current tobacco use include race (White vs. Black), partner current tobacco use, annual household income, financial security, time since diagnosis, physical health-related quality of life, depressed/anxious mood, social support, and family cohesion. Overall, these findings highlight the important role that psychosocial functioning, particularly family dynamics, and financial status play in tobacco use behavior following a cancer diagnosis. Clinical implications and considerations for future research are discussed.


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Available for download on Friday, December 12, 2025