More than a risk factor: alcohol use following diagnosis in non-small cell lung cancer patients.

BACKGROUND: Alcohol consumption is a leading preventable cause of cancer worldwide. Although common after cancer diagnosis, post-diagnosis alcohol use remain poorly understood. This gap is particularly salient among individuals with lung cancer, where understanding modifiable health behaviors have important implications for patient outcomes and clinical care. This study characterized longitudinal patterns and predictors of alcohol use following advanced lung cancer diagnosis. METHODS: Patients with stage IV non-small cell lung cancer (NSCLC; N = 326) were enrolled at diagnosis and completed self-report measures through 12-months post-diagnosis. Alcohol use was assessed as status (no use/any use), frequency, and quantity. Hierarchical mixed-effects models examined alcohol use trajectories and sociodemographic predictors. RESULTS: At baseline, 49% (n = 159) of patients reported alcohol use. The odds of reporting any alcohol use declined significantly over time (OR = 0.72, p = 0.010), with the greatest reductions occurring in the first two months post-diagnosis. Among drinkers, alcohol frequency remained low, but quantity increased after Month 2. After Month 6, the likelihood of alcohol use increased and was no longer significantly different from baseline. Higher education and income were associated with greater likelihood of alcohol use. Smoking history was associated with higher frequency and quantity in drinkers. CONCLUSIONS: This study provides the first longitudinal evidence on alcohol use following NSCLC diagnosis. Alcohol use declined substantially after diagnosis, but reductions were not sustained, underscoring the need for continued assessment throughout survivorship. Future studies are needed to understand the impact of post-diagnosis alcohol use on outcomes and develop evidence-based guidance for patient care.