Seokhun Kim

Background: Survivors of young adult (YA) cancer often experience substantial stress during the transition to survivorship, which may impair sleep. Although the stress–sleep link is well established, its role within survivor–spouse dyads remains unclear. Emotional intimacy may influence how couples regulate stress and affect sleep. This study examined dyadic associations between stress and sleep among survivors of YA cancer and their spouses and significant others (hereafter spouses) and tested emotional intimacy as a moderator. Methods: A total of 103 survivor of YA cancer–spouse dyads completed self‐reported measures of stress, emotional intimacy, and sleep quality. An actor‐partner interdependence moderation model was used to test how each person's stress was related to their own and their spouse's sleep quality and the moderating role of emotional intimacy. Results: In our model, higher stress was associated with poorer sleep quality among both survivors ( β = 0.405, p < 0.001) and spouses ( β = 0.172, p = 0.041), indicating significant actor effects, whereas no partner effects from stress were observed. Emotional intimacy moderated the stress‐sleep association among survivors ( β = −0.224, p = 0.004), but not among spouses ( β = −0.012, p = 0.892). Conclusions: Stress emerged as a key intrapersonal determinant of sleep quality for both survivors of young adult cancer and their spouses, indicating that stress management may benefit sleep in both groups. Emotional intimacy buffered stress‐related sleep disruption among survivors, but not spouses, highlighting role‐specific mechanisms. Tailored approaches may improve sleep and quality of life.

Supplementary Table S3: Goodness of fit of study sample and cohort.

Supplementary Table S6: Effects of insurance on abstinence and on cost, and abstinence on cost controlling for insurance

Supplementary Table S5: Insurance class for all patients

Supplementary Table S2: Sample size by Quarter

Supplementary Table S1: Definition of “Treatment”

Supplementary Table S4: Covariate balance before and after applying inverse probability of treatment weights (IPTW) with the threshold of standardized mean difference (SD) being 0.1

Supplementary Table S2: Sample size by Quarter

Continuous tobacco use in patients with cancer is linked to substantial healthcare costs due to increased risks and complications, whereas quitting smoking leads to improved treatment outcomes and cost reductions. Addressing the need for empirical evidence on the economic impact of smoking cessation, this study examined the association between smoking cessation and healthcare cost utilization among a sample of 930 patients with cancer treated at The University of Texas MD Anderson Cancer Center's Tobacco Research and Treatment Program (TRTP). Applying conditional quantile regression and propensity scores to address confounding, our findings revealed that abstinence achieved through the TRTP significantly reduced the median cost during a 3-month period post-quitting by $1,095 [β = −$1,095, P = 0.007, 95% confidence interval (CI), = (−$1,886 to −$304)]. Sensitivity analysis corroborated these conclusions, showing a pronounced cost reduction when outlier data were excluded. The long-term accrued cost savings from smoking cessation could potentially offset the cost of participation in the TRTP program, underscoring its cost effectiveness. An important implication of this study is that by reducing smoking rates, healthcare systems can more efficiently allocate resources, enhance patient health outcomes, and lessen the overall cancer burden.Prevention Relevance:This study emphasizes the dual impact of smoking cessation programs in patients with cancer: quitting smoking and reducing healthcare costs. It highlights the importance of integrating cessation programs into cancer prevention strategies, ensuring both individual health benefits and broader, system-wide economic efficiencies.See related Spotlight, p. 197

Supplementary Table S4: Covariate balance before and after applying inverse probability of treatment weights (IPTW) with the threshold of standardized mean difference (SD) being 0.1