Integration of a smoking cessation program in the treatment protocol for patients with head and neck and lung cancer

Abstract

Smoking is the main causative factor for development of head and neck and lung cancer. In addition, other malignancies such as bladder, stomach, colorectal, kidney and pancreatic cancer have a causative relation with smoking. Continued smoking after having been diagnosed with cancer has many negative consequences: effectiveness of radiotherapy is diminished, survival time is shortened and risks of recurrence, second primary malignancies and treatment complications are increased. In view of the significant health consequences of continued smoking, therefore, additional support for patients to stop smoking seems a logical extension of the present treatment protocols for smoking-related cancers. For prospectively examining the effect of nursing-delivered smoking cessation programme for patients with head and neck or lung cancer, 145 patients with head and neck or lung cancer enrolled into this programme over a 2-year period. Information on smoking behaviour, using a structured, programme specific questionnaire, was collected at baseline, and after 6 and 12 months. At 6 months, 58 patients (40%) had stopped smoking and at 12 months, 48 patients (33%) still had refrained from smoking. There were no differences in smoking cessation results between patients with head and neck and lung cancer. The only significant factor predicting success was whether the patient had made earlier attempts to quit smoking. A nurse-managed smoking cessation programme for patients with head and neck or lung cancer shows favourable long-term success rates. It seems logical, therefore, to integrate such a programme in treatment protocols for smoking-related cancers.

Factors associated with smoking abstinence among smokers and recent-quitters with lung and head and neck cancer

“…This finding is consistent with other studies that have found that use of evidence-based treatments to assist with smoking cessation among smokers with cancer have not been adequately utilized [8, 22, 36]. Among highly addicted smokers more intensive smoking cessation interventions may be needed to enhance abstinence rates [37, 38]. …”

Statement on smoking cessation in COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit

“…Despite high levels of nicotine dependence [85], smoking cessation rates in general cancer patients [87] and lung cancer patients [88] are comparable with "healthy" controls. For example, 40-53% of lung, and head and neck cancer patients were abstinent 6 months following treatment [89,90].…”

“…Characteristics of lung cancer patients who continue to smoke ∼10-13% of people still smoke 6 months following a diagnosis of lung cancer [88][89][90]. Younger age, depression, and having a household member who smokes are factors that are associated with not quitting [91].…”

Developing a follow‐up surveillance protocol in head and neck oncological surgery: enhanced ‘traffic light’ surveillance – a prospective feasibility study

“…The prevention of recurrence where risk factors are modifiable is far more efficacious than treating recurrent disease even when detected early . It has been recommended that patients be offered support with tobacco and alcohol cessation services as part of their follow‐up process .…”