It’s an incredibly scary thing to get a cancer diagnosis and awful to have to undergo chemotherapy or radiation. But it is amazing when the treatment works and the cancer goes into remission. Survivors can truly celebrate life and are often very conscious of doing whatever they can to maintain their good health in every way. But there is a segment of survivors that bucks that trend, and, according to new research, there are more than a few of them who continue to partake in one of the most hazardous habits: smoking.

The study, which was conducted by the American Cancer Society, found that close to 10 percent of cancer survivors continue to smoke nearly 10 years after beating the disease. Norton, Amy. “1 in 10 Cancer Survivors Still Smokes Years Later.” WebMD. 6 August 2014. Accessed 14 August 2014. The subjects were approximately 3,000 American men and women who were participants in a follow-up trial involving adults who had survived various forms of cancer. Lifestyle habits were reported on throughout the years and nearly a decade after the cancer diagnosis was made, close to 10 percent of these survivors admitted that they were still smokers.

Not only had they not given up the habit, but the majority were smoking fairly heavily. The average in this group was 15 cigarettes a day, but for 40 percent of them, it was even more. The winner of the dubious distinction of survivors with the highest rates of smoking a decade later (at 17 percent) went to those who had beaten bladder cancer. And astoundingly, a very close second place (at 15 percent) went to those who had survived lung cancer, for which smoking is a major contributing factor. It is just difficult to believe that after dealing with such a terrible disease and the often debilitating treatments typically used to eradicate lung cancer anyone could still have any desire for a cigarette.

The bright note in the data collected by the scientists was that among the newly diagnosed cancer patients who were smokers, one-third were indeed motivated and able to immediately kick the habit. That also suggests that more than half did eventually give up smoking at some point between the diagnosis and as they approached the 10-year mark, since it was just under 10 percent still puffing away at that mark.

The question remains why this group stuck with smoking or possibly quit but returned to the habit at some point after dealing with cancer. But you don’t have to have survived cancer to be interested in protecting your health. While smoking is unquestionably one of the most unhealthy habits we can have–with links to not only various cancers but also chronic obstructive pulmonary disease (COPD), heart disease, and stroke–it is far from the only adverse behavior practiced by people who should know better. So we can just as easily ask why would a diabetic remain sedentary and overweight? Or why would a person with cardiovascular disease keep consuming burgers and ice cream? Or even why would someone who had developed melanoma continue sunbathing?¹ “Some Melanoma Survivors Still Use Tanning Beds, Skip Sunscreen.” Newswise. 1 April 2013. Accessed 15 August 2014. http://www.newswise.com/articles/some-melanoma-survivors-still-use-tanning-beds-skip-sunscreen

The answers are often rooted in the familiar daily routines/habits that many of us find very hard to break out of, sometimes even if we encounter a health scare of epic proportions. While it’s not that hard to make lifestyle changes incrementally, let’s face it, most of us can’t go from being a couch potato to a marathon runner in a few weeks. But we can go from spending most of our free time sitting in front of the television to taking a 15-minute walk before hitting the couch. Then it becomes easier to slowly increase the amount of time spent on cardiovascular activities as well as introduce other forms of exercise. And we can take modest steps, one at a time, toward improving our eating habits. Maybe starting with cutting portions back then moving on to making nutritional improvements in what we choose to eat.

As for smoking, whether you have been diagnosed with a disease or not, quitting cannot be optional. Use whatever you can to motivate yourself and recruit those around you to become your support network. Smoking affects your mouth, lungs, skin,² Okada, Haruko C.; et al. “Facial Changes Caused by Smoking: A Comparison Between Smoking and Nonsmoking Identical Twins.” Plastic and Reconstructive Surgery. November 2013. Accessed 15 August 2014. http://journals.lww.com/plasreconsurg/Abstract/2013/11000/Facial_Changes_Caused_by_Smoking___A_Comparison.10.aspx and just about every internal organ over time, so if you have any intention of staying healthy for the long-term, put some energy into kicking the habit.