The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support

Warren, Graham; Sobus, Samantha L.; Gritz, Ellen R.

doi:10.1016/s1470-2045(14)70266-9

Cited by 118 publications

(110 citation statements)

References 82 publications

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“…10,23 Continued smoking among cancer patients also stimulates proliferation and tumorigenesis and reduces apoptosis in cancer cells. 50 Exposures of cancer cells to smoking also increase multidrug resistance, which then increase the risks for cancer recurrence and decrease response to treatment. 50 Moreover, continuing smokers tend to develop more late-stage complications, such as impaired wound healing, vascular injury, or a direct irritant, 10,29 which may contribute to poor mortality.…”

Section: Discussionmentioning

confidence: 99%

“…50 Exposures of cancer cells to smoking also increase multidrug resistance, which then increase the risks for cancer recurrence and decrease response to treatment. 50 Moreover, continuing smokers tend to develop more late-stage complications, such as impaired wound healing, vascular injury, or a direct irritant, 10,29 which may contribute to poor mortality. Smokers tend to simultaneously engage in other risky health behaviors, such as substance abuse, problem drinking, physical inactivity, not adhering to medication regimens, and missing treatment days, 10,51 which may lead to worse mortality outcomes, although this study controlled for some of these risky behaviors, including problem drinking and nutritional status (BMI).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

Choi

Terrell

Bradford

et al. 2016

NICTOB

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Introduction: To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients. Methods: Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first. Based on smoking status, all patients were categorized into four groups: continuing smokers, quitters, former smokers, or never-smokers. A broad range of covariates were included in the analyses. Kaplan-Meier curves, bivariate and multivariate Cox proportional hazards models were constructed. Results: Eight-year overall mortality and cancer-specific mortality were 40.5% (239/590) and 25.4% (150/590), respectively. Smoking status after a cancer diagnosis predicted overall mortality and cancer-specific mortality. Compared to never-smokers, continuing smokers had the highest hazard ratio (HR) of dying from all causes (HR = 2.71, 95% confidence interval [CI] = 1.48-4.98). Those who smoked at diagnosis, but quit and did not relapse-quitters-had an improved hazard ratio of dying (HR = 2.38, 95% CI = 1.29-4.36) and former smokers at diagnosis with no relapse after diagnosis-former smokers-had the lowest hazard ratio of dying from all causes (HR = 1.68, 95% CI = 1.12-2.56). Similarly, quitters had a slightly higher hazard ratio of dying from cancer-specific reasons (HR = 2.38, 95% CI = 1.13-5.01) than never-smokers, which was similar to current smokers (HR = 2.07, 95% CI = 0.96-4.47), followed by former smokers (HR = 1.70, 95% CI = 1.00-2.89). Conclusions: Compared to never-smokers, continuing smokers have the highest HR of overall mortality followed by quitters and former smokers, which indicates that smoking cessation, even after a cancer diagnosis, may improve overall mortality among newly diagnosed head and neck cancer patients. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population. Implications: Using prospective observational longitudinal data from 590 head and neck cancer patients, this study showed that continuing smokers have the highest overall mortality relative to never-smokers, which indicates that smoking cessation, even after a cancer diagnosis, may have beneficial effects on long-term overall mortality. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

Choi

Terrell

Bradford

et al. 2016

NICTOB

View full text Add to dashboard Cite

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“…The process of metastasis may be classically divided into a number of steps: Invasion of tumor cells into the surrounding tissues, penetration of vessels and migration toward distant sites of the body away from the primary sites (74). At present, several clinical studies in humans revealed an association between smoking and an increase in the metastasis of lung cancer (75)(76)(77)(78). The α7nAChR is expressed in SCLC and NSCLC cells (24).…”

Section: Function and Mechanisms Of α7nachr On Metastasismentioning

confidence: 99%

α7 nicotinic acetylcholine receptors in lung cancer (Review)

Wang

2018

Oncol Lett

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Abstract. Lung cancer has one of the highest mortality rates among malignancies globally, and smoking has been documented as the main cause of lung cancer. Nicotinic acetylcholine receptors (nAChRs) were initially identified as notable regulators of the nervous system. In addition to their function in the brain, accumulating evidence indicates that nAChRs perform a host of diverse functions in almost all non-neuronal mammalian cells. The homomeric α7nAChR, a subtype of nAChRs, is responsible for the proliferative, pro-angiogenic and pro-metastatic effects of nicotine in lung cancer. Provided the association of cigarette smoking with several disease types such as cardiovascular disease, the α7nAChR-mediated signaling pathway has been implicated in the pathophysiology of lung cancer. Currently, strategies that target the α7nAChR including α7nAChR antagonists are considered to be potentially useful anticancer drugs for therapeutic purposes. Thus, the present review assesses current understanding of the function and underlying molecular mechanisms of α7nAChR in lung cancer and evaluates how targeting α7nAChR may result in novel therapeutic methods. IntroductionLung cancer is one of the most commonly occurring carcinoma types globally and has limited treatment options for advanced-stage disease (1). Lung cancer is a heterogeneous disease comprised of two main pathological types: Non-small-cell lung cancer (NSCLC) which accounts for 70-80% of all lung cancer cases and small-cell lung cancer (SCLC) which accounts for ~20% of all lung cancer cases (2). NSCLCs may be divided into three subtypes: Squamous-cell carcinoma (25-30% of all lung cancer cases), adenocarcinoma (~40% of all lung cancer cases) and large-cell carcinoma (10-15% of all lung cancer cases) (3). SCLC is the second most prevalent form of lung cancer, with a 5-year survival rate of <7% (4). Cigarette smoking is considered to be the main risk factor for lung cancer, and ~90% of all cases are associated with exposure to smoking and second-hand smoking (5). Other contributory factors include residential radon, occupational hazards including exposure to asbestos, arsenic and polycyclic aromatic hydrocarbons, radiation, coal smoke, indoor emission of fuel burning, outdoor pollution, previous non-malignant lung diseases in addition to a family history of tumors (6,7). Squamous-cell, large-cell and SCLC are the most commonly identified types of lung cancer present in smokers (8,9). In contrast, adenocarcinoma is the lung cancer type most commonly identified in non-smokers (10).Cigarette smoke is a mixture of thousands of chemical compounds, a number of which have potent carcinogenic potential including polycyclic aromatic hydrocarbons, nicotine and the nicotine-derived nitrosamines 4-(methylnitrosamino)-1-(3-pyrydyl)-1-butanone (NNK) and N-nitrosonornicotine (11). The most harmful and addictive component is nicotine (11). These carcinogens and their metabolites may induce the formation of DNA adducts which result in mutations of a number of key cancer suppressor...

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“…Evidence has shown that continued smoking by cancer patients leads to adverse cancer treatment outcomes and affects survival [4][5][6] . Smoking diminishes treatment effectiveness, particularly for radiation therapy and chemotherapy; it also exacerbates side effects, interferes with wound healing, and can be a risk factor for a wide range of pulmonary, cardiovascular, infectious, and woundrelated complications 3,4,[7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…Smoking diminishes treatment effectiveness, particularly for radiation therapy and chemotherapy; it also exacerbates side effects, interferes with wound healing, and can be a risk factor for a wide range of pulmonary, cardiovascular, infectious, and woundrelated complications 3,4,[7][8][9] . Patients who smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence.…”

Section: Introductionmentioning

confidence: 99%

Smoking Behaviours of Current Cancer Patients in Canada

et al. 2016

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Evidence shows that continued smoking by cancer patients leads to adverse treatment outcomes and affects survival. Smoking diminishes treatment effectiveness, exacerbates side effects, and increases the risk of developing additional complications. Patients who continue to smoke also have a higher risk of developing a second primary cancer or experiencing a cancer recurrence, both of which ultimately contribute to poorer quality of life and poorer survival. Here, we present a snapshot of smoking behaviours of current cancer patients compared with the non-cancer patient population in Canada.Minimal differences in smoking behaviours were noted between current cancer patients and the rest of the population. Based on 2011-2014 data from the Canadian Community Health Survey, 1 in 5 current cancer patients (20.1%) reported daily or occasional smoking. That estimate is comparable to findings in the surveyed non-cancer patient population, of whom 19.3% reported smoking daily or occasionally. Slightly more male cancer patients than female cancer patients identified as current smokers. A similar distribution was observed in the non-cancer patient population.There is an urgent need across Canada to better support cancer patients in quitting smoking. As a result, the quality of patient care will improve, as will cancer treatment and survival outcomes, and quality of life for these patients.

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The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support

Cited by 118 publications

References 82 publications

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

α7 nicotinic acetylcholine receptors in lung cancer (Review)

Smoking Behaviours of Current Cancer Patients in Canada

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