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Table of Contents Introduction
Overview
Smoking as a Primary Risk Factor
Poorer Treatment Response in Cancer Patients
Smoking as a Secondary Risk Factor
Effects of a Cancer Diagnosis on Quitting Smoking and Remaining Abstinent
Smoking Intervention in Cancer Patients
Treatment
Get More Information From NCI
Changes to This Summary (11/14/2008)
Questions or Comments About This Summary
About PDQ
Introduction
This patient summary on smoking cessation and continued risk in cancer patients
is adapted from a summary written for health professionals by cancer experts.
This and other credible information about cancer treatment, screening, prevention, supportive care, and ongoing clinical trials is available from the National Cancer Institute. This brief summary describes smoking and the risks
that continued smoking have on cancer patients.
Back to Top Overview
This summary briefly covers smoking as a primary risk factor for cancer, but
the main focus is on the effect of smoking on cancer recurrence and diagnosis of a second primary cancer; patterns of quitting and continued smoking in
cancer patients; and recommendations for cancer patients to quit smoking.
Information on cancer prevention and quitting smoking in healthy people is
readily available elsewhere. The information presented in this summary is
related to smoking, rather than using other forms of tobacco, such as snuff or
chewing tobacco.
Back to Top Smoking as a Primary Risk Factor
It has been known for almost 50 years that tobacco use can be linked to cancers of the lung and head and neck. Eighty-five percent of the cases of head and
neck cancer found each year are associated with tobacco use. Long-term smoking
that begins before age 30 also increases the risk for developing colorectal cancer. Smoking contributes to cancer development by causing mutations in genes, impairing lung function, and decreasing the effectiveness of the immune
system. (Refer to the PDQ summary on Lung Cancer Prevention for more
information.)
Back to Top Poorer Treatment Response in Cancer Patients
If cancer is diagnosed in a smoker, studies have found that quitting smoking
will still be helpful. Even
recent quitters are more likely to recover from cancer than smoking patients are. Continuing to smoke may decrease the effectiveness of
treatment and may worsen treatment side effects. For example, patients who
have received radiation therapy for laryngeal cancer are less likely to regain
satisfactory voice quality if they continue to smoke. Also, wound healing
following surgery will be more difficult if one continues to smoke.
Back to Top Smoking as a Secondary Risk Factor
Whether a patient has a cancer that is smoking-related or nonsmoking related,
he or she is at increased risk of developing a second cancer at the same or
another site, if smoking is not stopped. The risk of developing a second
cancer may persist for up to 20 years, even if the original cancer has been
successfully treated.
Patients with oral and pharyngeal cancers who smoke also have a high rate of second primary cancers. The risk decreases significantly, however, after 5
years of not smoking.
Back to Top Effects of a Cancer Diagnosis on Quitting Smoking and Remaining Abstinent
Most people who have a smoking-related cancer stop smoking or make
serious efforts to quit when cancer is diagnosed. Patients who do not
immediately stop smoking may be motivated to quit in the future. Some studies
have shown that patients who have less intensive treatment are more likely to
continue smoking, and if they quit, are more likely to start smoking again.
Back to Top Smoking Intervention in Cancer Patients
Although smoking cessation research has been conducted in other patient groups,
especially heart patients, few studies have involved cancer patients. These
studies have shown the importance of involvement of physicians and other health
care professionals in helping patients to stop smoking. The ASK, ADVISE,
ASSIST, and ARRANGE model was developed in the late 1980s for health care
providers and their patients who smoke. Using this model, the physician asks
the patient about smoking status at every visit, advises the patient to stop
smoking, assists the patient by setting a date to quit smoking, provides self-
help materials, recommends use of nicotine replacement therapy (for example,
the nicotine patch), and arranges for follow-up visits.
Not all smokers are motivated to stop smoking. Physicians should help patients
become motivated to quit smoking. It is common for first time quitters to
start smoking again once or many times. Quitters should be taught to
anticipate stressful situations in which they will want to smoke, and to
develop strategies for handling them. It may take more than a year for even
motivated smokers to stop smoking. The National Cancer Institute booklet, Online Guide to Quitting may help patients understand reasons for smoking and the best ways to quit.
Back to Top Treatment
The drugs bupropion and fluoxetine have been found to be successful
in helping healthy people stop smoking. They have not, however, been studied
in people with cancer.
Nicotine products, such as nicotine inhalers, nicotine gum, and nicotine
patches, may help with the withdrawal symptoms that one experiences when trying
to stop smoking. Several precautions should be considered, and a physician
should be consulted before beginning any form of treatment.
Back to Top Get More Information From NCI
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
Chat online
The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
Write to us
For more information from the NCI, please write to this address:
- NCI Public Inquiries Office
- Suite 3036A
- 6116 Executive Boulevard, MSC8322
- Bethesda, MD 20892-8322
Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
Back to Top Changes to This Summary (11/14/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
Back to Top Questions or Comments About This Summary
If you have questions or comments about this summary, please send them to Cancer.gov through the Web site’s Contact Form. We can respond only to email messages written in English.
Back to Top About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one method of treating symptoms is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. Some patients have symptoms caused by cancer treatment or by the cancer itself. During supportive care clinical trials, information is collected about how well new ways to treat symptoms of cancer work. The trials also study side effects of treatment and problems that come up during or after treatment. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients who have symptoms related to cancer treatment may want to think about taking part in a clinical trial.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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