se patients continue smoking despite the risk, but the rate of relapse ranged from a low of 13 percent to about 60 percent. This study was unique in that it sought to include patients believed to be highly dependent on nicotine - so it included only patients who smoked within three months of their diagnosis - and it attempted to use saliva samples as well as questionnaires to gauge whether patients were smoking 3, 6, and 12 months after surgery.

Investigators at Washington University and at the University of Texas M.D. Anderson Cancer Center enrolled 154 patients being treated for early stage lung cancer at their centers. These patients were lucky, Walker said. "Their cancer was discovered largely by accident when they were being examined for other medical conditions, and so was potentially curable by surgery," he said. "More than two-thirds of lung cancer is diagnosed at later stages in people with symptoms, and treatment is much less successful."

The researchers found that 43 percent of patients smoked at some point after surgery and 37 percent were smoking 12 months after their operation.

Consistent with previous research, the investigators hypothesized that greater nicotine dependence; a younger age, lower income, and a lower level of education would be associated with a greater likelihood of smoking post surgery.

But that is not what they saw on two of the four variables. Instead, researchers found no link between the quantity of smoking and the ability to quit, and they also were surprised to discover that higher education was associated with a greater likelihood of smoking after surgery. "It wasn’t the number of cigarettes smoked daily that determined who couldn’t quit, but how long they continued to smoke before surgery. About half of the patients studied smoked within two weeks of their operation," Walker says. "We are not certain what to make of the finding about education, because no other study about smoking cessa
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