New research suggests that cancer survivors who smoke perceive less risk from the habit.

Researchers found that cancers survivors who smoke report fewer negative opinions about smoking, have more barriers to quitting, and are around other smokers more often than survivors who had quit before or after their diagnosis.

Although initial quit rates are high among those diagnosed with cancers linked with smoking, such as lung and neck cancer, many relapse and begin smoking again. Also, survivors of other cancers may not be aware of the connection between their smoking and cancer prognosis and may not receive cessation advice or follow-up assistance during cancer treatment.

For the study, researchers examined psychological correlates of smoking status and patterns, likelihood of quitting, and intentions to quit among long-term survivors enrolled in the American Cancer Society's Study of Cancer Survivors-I (SCS-I), a longitudinal nationwide study of adult survivors of 10 commonly diagnosed cancers.

They found that survivors who currently smoked (compared with those who quit before or after diagnosis) perceived health problems caused by smoking as less severe, perceived fewer benefits of quitting for cancer survivors, saw greater barriers to quitting, and reported more daily exposure to others' smoking.

The analysis also found that cancer survivors who intended to quit rated the risks of smoking as higher and as more severe than survivors who weren't intending to quit or who weren't sure if they wanted to quit. Survivors intending to quit were also less likely to see benefits from smoking, and survivors who didn't smoke every day were much less exposed to others' smoke, and had greater confidence in their ability to quit.

"The association between smoking and exposure to others' smoke was particularly eye-opening," Dr. Lee Westmaas, who led the study, said in a statement. "Being around other smokers may be a major reason why cancer survivors are smoking and should be something that is addressed in recommending treatments for helping cancer patients quit."

Westmaas adds that health care providers may want to include family members who smoke in efforts to encourage cessation for smokers.

The findings are detailed in the journal Psycho-Oncology.