Smoking and cancer

Continued smoking during cancer treatment.

smoking and cancerThere is substantial evidence that smoking and cancer have an impact on health outcomes. Evidence shows that continued smoking may reduce the effectiveness of chemotherapy and radiation therapy as well as increase the likelihood of a second cancer. Fortunately, improvements in the body’s ability to function begin within 24 hours of a patient quitting smoking. But the longer you stop smoking, the better, and eventually completely stopping is the best.

In some cancers (such as lung cancer), studies have suggested that outcomes are better for those who quit smoking at diagnosis compared to those who continue smoking. People who quit smoking often feel that they have more energy almost immediately, which could certainly be a benefit when chemotherapy-induced fatigue sets in. Smoking can, among others, irritate mouth sores (a common side effect of chemotherapy) or affect the ability to taste, which can make eating even more difficult while going through therapy – both good reasons to quit. Some studies even suggest that the chemicals related to smoking might have an impact on the chemical pathways that chemotherapy uses.

Smoking and cancer: a risk factor for second malignancy

People who initially have smoking-related and non–smoking-related malignancy face increased risk of a second malignancy at the same site or another site if they continue to smoke.

When prognosis is more favorable for the initial cancer, the evidence is even stronger that continued smoking increases the risk of new primary cancers for up to 20 years after original diagnosis.

Smoking and cancer: when must a diagnosed patient stop smoking?

A stepped-care approach to quitting is recommended, with strong physician advice and brief counseling to quit. For those having difficulty quitting or remaining abstinent provision of basic information during the first month of diagnosis, followed by more intensive treatment (pharmacologic and counseling by a smoking specialist) should be provided to each patient.

Patients can be carefully matched to specific smoking cessation strategies. Some smokers can quit with the help of counseling or psychological interventions, others might need nicotine replacement therapies, while other smokers might need medications to successfully quit smoking. Given the significant health benefits derived from smoking cessation, medications can be used with these patients with careful monitoring.

Quitting smoking is not easy, as smoking and cancer are not the best combination. But fortunately there are options for assistance including medications and behavioral modification techniques. It is important for smokers to discuss this with their physicians so appropriate strategies can be developed to help them quit their habits and stay off the cancer sticks.


International Journal of Radiation Oncology, Biology, Physics(Vol. 71:4, pp. 1134-1142)

Related articles:

– Smoking and Cancer. Tobacco use during treatment

– Smoking Infographic