A review of the effects of tobacco smoking on cancer treatment: smoking cessation intervention should be integrated into the cancer care continuum

Abstract

Background:The adverse health effects associated with smoking tobacco have been well investigated, and its detrimental effects on cancer treatment outcomes, efficacy and quality of life (QOL) for cancer patients have also been well documented. Tobacco smoke contains many thousands of chemicals, including a plethora of carcinogens, and the exposure of human cells to these carcinogens, and their metabolic activation, is the main mechanism by which smoking-related cancer is initiated.Materials and Methods:This paper reports on a narrative review of recent studies in the field of effects of tobacco smoking on cancer treatment, including the effects of carcinogens in smoke on carcinogenesis, cell mutations and the immune system. The health effects of smokeless tobacco, effects of tobacco smoking on cancer treatment, and its impact on surgery, radiation therapy and chemotherapy are reported. The potential risks of second primary cancers or recurrence from tobacco use, the effects of second-hand smoking and cancer treatment, the impact of smoking on the QOL after cancer treatment and the need to integrate smoking cessation programs into the cancer care continuum are also reported.Conclusions:Tobacco use has a direct impact on cellular function by inhibiting apoptosis, stimulating proliferation and decreasing the efficacy of cancer treatment; therefore, quitting its use has the potential to improve treatment response rates and survival, as well as reduces the risk of developing second cancers and potentially improves the QOL after treatment. Smoking cessation is one of the most important interventions to prevent cancer and is also essential after the diagnosis of cancer to improve clinical outcomes. Due to the numerous benefits of smoking cessation, it should become a critical component of the cancer care continuum in all oncology programs – from prevention of cancer through diagnosis, treatment, survivorship and palliative care. Evidence-based smoking cessation intervention should be sustainably integrated into any comprehensive cancer program, and the information should be targeted to the specific benefits of cessation in cancer patients.

Implementation of a Smoking Cessation e‐Learning Education Program for Oncology Clinic Healthcare Providers: Evaluation With Implications for Evidence‐Based Practice

“…About half of cancer patients smoke routinely prior to their diagnosis, and two‐thirds that are current smokers at the time of diagnosis continue to smoke after their diagnosis (Tseng, Lin, Moody‐Thomas, Martin, & Chen, 2012). Continuing to smoke after a cancer diagnosis reduces treatment effectiveness, decreases quality of life, decreases survival time, and increases the risk of developing a second primary cancer (Kassim, Osei, & Cronin, 2020).…”

Supporting cancer patients quit smoking: the initial evaluation of our tobacco cessation intervention program

“…5 Tobacco use is also responsible for more than 7 million deaths per year worldwide. 1 Several studies 1,[6][7][8] have shown that tobacco use is causally associated with several cancers including cancers of the lungs, oropharynx and larynx, esophagus, stomach, pancreas, kidneys and ureters, cervix and bladder as well as acute myeloid leukemia.…”

“…For patients undergoing cancer treatment, tobacco smoking can potentially compromise treatment efficacy, overall survival, diseasefree survival, and quality of life. 8 Furthermore, it poses a unique risk of increased disease recurrence, second primary tumors, surgical complications, increased toxicities after radiotherapy, increased length of hospital stay after surgery and increased cancer-specific mortality. 3,5,8,9 However, there is sufficient evidence suggesting numerous benefits of smoking cessation interventions for cancer patients.…”

“…8 Furthermore, it poses a unique risk of increased disease recurrence, second primary tumors, surgical complications, increased toxicities after radiotherapy, increased length of hospital stay after surgery and increased cancer-specific mortality. 3,5,8,9 However, there is sufficient evidence suggesting numerous benefits of smoking cessation interventions for cancer patients. 8,[10][11][12] The health benefits of smoking cessation for oncology patients include improved cancer prognosis, better response to therapy (i.e., surgery, radiotherapy, chemotherapy), reduced radio-toxicities, relatively faster healing after surgery, reduced surgical complications, low risk of recurrence and second cancers and reduction in overall and cancer-specific and premature mortalities.…”

“…3,5,8,9 However, there is sufficient evidence suggesting numerous benefits of smoking cessation interventions for cancer patients. 8,[10][11][12] The health benefits of smoking cessation for oncology patients include improved cancer prognosis, better response to therapy (i.e., surgery, radiotherapy, chemotherapy), reduced radio-toxicities, relatively faster healing after surgery, reduced surgical complications, low risk of recurrence and second cancers and reduction in overall and cancer-specific and premature mortalities. 8,13,14 According to the 2014 Surgeon General's report, 1 the risk of cancer patients dying from the disease could be reduced by about 30-40% if they quit smoking at the time of their diagnosis.…”