Smoking cessation in cancer patients
Stopping smoking after a cancer diagnosis improves survival, reduces treatment complications and second cancers, and is the single most effective supportive intervention that oncology services still routinely fail to deliver.
Continued smoking after diagnosis increases all-cause and cancer-specific mortality (2014 Surgeon General's report: about 50% higher risk of death in lung and head and neck cancer), impairs wound healing and radiotherapy response, increases chemotherapy toxicity and treatment interruptions, and raises the risk of second primary cancers. Quitting within months of diagnosis of early lung cancer improves survival by around a third in cohort studies and a randomised trial of intensive cessation support in the ELCAP and Moscow cohorts (Annals of Internal Medicine 2021) showed better survival. Evidence-based treatment is varenicline or cytisine plus behavioural support, which doubles or triples quit rates. Despite this, fewer than half of cancer centres systematically assess and treat tobacco use; the NCI Cancer Center Cessation Initiative (C3I) and the UK's opt-out 'Cure' model demonstrate that embedding cessation into oncology pathways lifts treatment rates from single digits to over 50%.
How it works
Removing ongoing carcinogen exposure and hypoxia-inducing carboxyhaemoglobin improves radiotherapy oxygen enhancement and drug metabolism, halts field cancerisation, and lowers cardiovascular competing risk.
- Large survival effect in lung and head and neck cancer
- Cheap, effective drugs available
- Opt-out models are proven to raise uptake
- Under-delivered: most patients never offered treatment
- Stigma and fatalism among patients and clinicians
- Reimbursement gaps for cessation pharmacotherapy
Latest papers
topQuery for this technology: (TITLE:"Smoking cessation in cancer patients" OR ABSTRACT:"Smoking cessation in cancer patients") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Smoking cessation in cancer patients, not a curated reading list.
Pages like this
not linked directly; found by shared links- Key paperFifty years of the British Doctors Study: smokers lose ten years of life, quitting gives most of it back
Shares Every lung screening visit includes stop-smoking medicine, opt-out, Small-cell lung cancer, Prevention we already have is not deployed, Bladder & urothelial cancer.
- InstitutionMarkey Cancer Center, University of Kentucky
Shares Low-dose CT lung screening, Fragmented care and guideline gaps, Prevention we already have is not deployed, Cervical cancer.
- InstitutionMUSC Hollings Cancer Center
Shares Low-dose CT lung screening, Prevention we already have is not deployed, Head and neck squamous cell carcinoma, Non-small-cell lung cancer.
- InstitutionZhejiang Cancer Hospital
Shares Oesophageal cancer, Cervical cancer, Head and neck squamous cell carcinoma, Non-small-cell lung cancer.
- Key paperNLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers
Shares Low-dose CT lung screening, Small-cell lung cancer, Prevention we already have is not deployed, National Cancer Institute (NIH).
- InstitutionShandong Cancer Hospital and Institute
Shares Small-cell lung cancer, Oesophageal cancer, Head and neck squamous cell carcinoma, Non-small-cell lung cancer.
- TermSquamous cell carcinoma (SCC)
Shares Oesophageal cancer, Cervical cancer, Head and neck squamous cell carcinoma, Non-small-cell lung cancer.
- IdeaProtect hearing from cisplatin in adults as we now do in children
Shares Bladder & urothelial cancer, Head and neck squamous cell carcinoma, Non-small-cell lung cancer.