It is well known that ongoing tobacco use is associated with poorer survival in patients with cancer. This committee works to provide lung cancer care providers with tools to reinforce tobacco assessment and enhance cessation support. From recommendations for global governments to toolkits for care providers, the Tobacco Control and Smoking Cessation Committee is active and engaged at all levels.
Chair of Committee
IASLC Position Statement on Tobacco Cessation After a Cancer Diagnosis
Tobacco use is a well-established cause of cancer and contributes to about 1 in 3 cancer deaths. Whereas the harmful effects of smoking on health are well recognized, the negative impacts of continued smoking after a diagnosis of cancer are under appreciated. The substantial body of research reviewed in the 2014 US Surgeon General’s Report concluded that smoking by cancer patients and survivors causes adverse outcomes, including increased overall mortality and cancer-related mortality, greater risk of a second primary cancer, and associations with substantially worse toxicity from cancer treatments. The clinical effects of smoking after a diagnosis of cancer also substantially increase the cost of cancer care. The 2020 US Surgeon General’s Report reported that smoking cessation after a cancer diagnosis is associated with improved survival, and quitting smoking provides significant benefits for non-cancer-related health outcomes. The recommendations are available in English, Spanish, Portugese, Japanese, Chinese, and Polish.
National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology – Smoking Cessation
Tobacco smoking has been implicated in causing cancers of the lungs, mouth, lips, nose, sinuses, larynx, pharynx, esophagus, stomach, pancreas, kidney, bladder, uterus, cervix, colon/rectum, ovary, and myeloid leukemia.1 Cancers linked to tobacco use comprise 40% of all cancer diagnoses, and cigarette smoking is linked to 30% of all cancer-related deaths nationwide.2 State-level data suggest that cigarette smoking is responsible for as high as 40% of cancer-related deaths in some geographic regions.3 Lung cancer is the leading cause of cancer-related death in both males and females.4 The recommendations in these guidelines apply to the cessation of cigarette smoking, which poses the greatest risk to patients with cancer. Regardless of stage or treatment modalities, all patients should be encouraged to achieve and maintain abstinence from all combustible tobacco products (e.g., cigarettes, cigars, hookah) and smokeless tobacco products. Smoking cessation has health benefits even after a cancer diagnosis, regardless of site, stage, or prognosis—namely, improvement in cancer treatment outcomes, primary cancer recurrence, and secondary cancers. Importantly, a diagnosis of cancer may present a teachable moment and valuable opportunity for providers to encourage smoking cessation.5-8 It is the view of the NCCN Smoking Cessation Panel that it is never too late for patients with cancer at any stage to stop smoking cigarettes and experience health benefits.
- 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69:7–34.30620402
- 2. CDC Vital Signs: Cancer and tobacco use. Accessed January 12, 2023. Available at: https://www.cdc.gov/vitalsigns/pdf/2016-11-vitalsigns.pdf
- 3. Goding SauerA, SiegelRL, et al.State-level cancer mortality attributable to cigarette smoking in the United States. /JAMA Intern Med/2016;176:1792–1798
- 4. SiegelRL, MillerKD, FuchsHE, et al.Cancer statistics, 2022. /CA Cancer J Clin/2022;72:7–33
- 5-8. CarrollAJ, Veluz-WilkinsAK, BlazekovicS, et al.Cancer-related disease factors and smoking cessation treatment: analysis of an ongoing clinical trial. /Psychooncology/2018;27:471–476. GritzER, FingeretMC, VidrineDJ, et al.Successes and failures of the teachable moment: smoking cessation in cancer patients. /Cancer/2006;106:17–27 WestmaasJL, NewtonCC, StevensVL, et al.Does a recent cancer diagnosis predict smoking cessation? An analysis from a large prospective US cohort. /J Clin Oncol/2015;33:1647–1652. TangMW, OakleyR, DaleC, et al.A surgeon led smoking cessation intervention in a head and neck cancer centre. /BMC Health Serv Res/2014;14:636