Prevention and Cessation of Cigarette Smoking
Avoiding risk factors and increasing protective factors may help prevent cancer.
Avoiding cancer risk factors such as smoking, being overweight, and lack of exercise may help prevent certain cancers. Increasing protective factors such as quitting smoking, eating a healthy diet, and exercising may also help prevent some cancers. Talk to your doctor or other health care professional about how you might lower your risk of cancer.
The Public Health Service has a set of guidelines called Treating Tobacco Use and Dependence 1. It asks health care professionals to talk to their patients about the health problems caused by smoking and the importance of quitting smoking.
Quitting smoking improves health in smokers of all ages.
The risk of most health problems from smoking, including cancer and heart and lung disease, can be lowered by stopping smoking. People of all ages can improve their health if they quit smoking. Quitting at a younger age will improve a person's health even more. People who quit smoking cut their risk of lung cancer by 30% to 50% after 10 years compared to people who keep smoking, and they cut their risk of cancer of the mouth or esophagus in half within 5 years after quitting.
The damage caused by smoking is even worse for people who have had cancer. They have an increased risk of cancer recurrence, new cancers, and long-term side effects from cancer treatment. Quitting smoking and stopping other unhealthy behaviors can improve long-term health and quality of life. See the PDQ summary Smoking Cessation and Continued Risk in Cancer Patients 2 for more information.
Different ways to quit smoking have been studied. The following are the most common methods used to help smokers quit:
People who have even a short counseling session with a health care professional are more likely to quit smoking. Your doctor or other health care professional may take the following steps to help you quit:
- Ask about your smoking habits at every visit.
- Advise you to stop smoking.
- Ask you how willing you are to quit.
- Help you plan to quit smoking by:
- setting a date to quit smoking;
- giving you self-help materials;
- recommending drug treatment.
- Plan follow-up visits with you.
Childhood cancer survivors who smoke may be more likely to quit when they take part in programs that use peer-counseling . In these programs, childhood cancer survivors are trained in ways to give support to other childhood cancer survivors who smoke and want to quit. More people quit smoking with peer-counseling than with self-help programs. If you are a childhood cancer survivor and you smoke, talk to your doctor about peer-counseling programs.
Treatment with drugs is also used to help people quit smoking. These include nicotine replacement products and non-nicotine medicines. People who use any type of drug treatment are more likely to quit smoking after 6 months than those who use a placebo or no drug treatment at all.
Nicotine replacement products have nicotine in them. You slowly reduce the use of the nicotine product in order to reduce the amount of nicotine you take in. Using a nicotine replacement product can help break the addiction to nicotine. It lessens the side effects of nicotine withdrawal, such as feeling depressed or nervous, having trouble thinking clearly, or having trouble sleeping. Nicotine replacement products that have been shown to help people quit smoking include:
Nicotine replacement products can cause problems in some people, especially:
- Women who are pregnant or breast feeding.
- Teenagers.
- People with any of the following medical problems:
- Heart rhythm problems.
- High blood pressure that is not controlled.
- Esophagitis.
- Ulcers.
- Insulin -dependent diabetes.
- Asthma.
Other medicines that do not have nicotine in them are used to help people quit smoking. These include:
These medicines lessen nicotine craving and nicotine withdrawal symptoms.
It is important to know that bupropion and varenicline may cause serious psychiatric problems. Symptoms include:
- Changes in behavior.
- Aggressive behavior.
- Anxiety.
- Nervousness.
- Depression.
- Suicidal thoughts and attempted suicide.
Before starting to take bupropion or varenicline, talk to your doctor about the important health benefits of quitting smoking and the small but serious risk of problems with the use of these drugs.
Varenicline may also cause serious heart problems.
When smokers do not quit smoking completely but smoke fewer cigarettes (smoking reduction). they may still benefit. The more you smoke, the higher your risk of lung cancer and other cancers related to smoking. Studies show that smokers who cut back are more likely to stop smoking in the future.
Smoking less is not as helpful as quitting smoking altogether, and is harmful if you inhale more deeply or smoke more of each cigarette to try to control nicotine cravings. In smokers who do not plan to quit smoking completely, nicotine replacement products have been shown to help them cut down the number of cigarettes they smoke, but this effect does not appear to last over time .
The following resources can help you quit smoking:
- Consumer information about quitting smoking is available at the www.smokefree.gov Web site.
- The online Quit Guide 3 may help you understand reasons for smoking and the best ways to quit.
- The booklet Clearing the Air: Quit Smoking Today can be ordered at 1-800-4-CANCER (1-800-422-6237) or printed here 4.
Cancer prevention clinical trials are used to study ways to prevent cancer.
Cancer prevention clinical trials are used to study ways to lower the risk of developing certain types of cancer. Some cancer prevention trials are conducted with healthy people who have not had cancer but who have an increased risk for cancer. Other prevention trials are conducted with people who have had cancer and are trying to prevent another cancer of the same type or to lower their chance of developing a new type of cancer. Other trials are done with healthy volunteers who are not known to have any risk factors for cancer.
The purpose of some cancer prevention clinical trials is to find out whether actions people take can prevent cancer. These may include eating fruits and vegetables, exercising, quitting smoking, or taking certain medicines, vitamins, minerals, or food supplements.
New ways to help smokers quit are being studied in clinical trials.
Clinical trials are taking place in many parts of the country. Information about clinical trials can be found in the Clinical Trials section of the NCI Web site 5. Check for clinical trials in NCI's PDQ Cancer Clinical Trials Registry that are accepting patients for trials to quit smoking 6.
Glossary Termsaddiction (uh-DIK-shun)Uncontrollable craving, seeking, and use of a substance such as a drug or alcohol.anxiety (ang-ZY-eh-tee) Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.asthma (AZ-muh) A chronic disease in which the bronchial airways in the lungs become narrowed and swollen, making it difficult to breathe. Symptoms include wheezing, coughing, tightness in the chest, shortness of breath, and rapid breathing. An attack may be brought on by pet hair, dust, smoke, pollen, mold, exercise, cold air, or stress.breast (brest) Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.bupropion (byoo-PROH-pee-ON) A substance that is used to treat depression, and to help people quit smoking. It belongs to the family of drugs called antidepressants.cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.Chantix (CHAN-tix) A drug used to help people stop smoking by acting the same way nicotine acts in the brain. It is a type of nicotine receptor partial agonist. Also called varenicline tartrate.clinical trial (KLIH-nih-kul TRY-ul) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.counseling (KOWN-suh-ling) The process by which a professional counselor helps a person cope with mental or emotional distress, and understand and solve personal problems.depression (dee-PREH-shun) A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.diabetes (dy-uh-BEE-teez) Any of several diseases in which the kidneys make a large amount of urine. Diabetes usually refers to diabetes mellitus in which there is also a high level of glucose (a type of sugar) in the blood because the body does not make enough insulin or use it the way it should.diet (DY-et) The things a person eats and drinks.drug (drug) Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.esophagitis (ee-SAH-fuh-JY-tis) Inflammation of the esophagus (the tube that carries food from the mouth to the stomach).esophagus (ee-SAH-fuh-gus) The muscular tube through which food passes from the throat to the stomach.follow-up (FAH-loh-up) Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.high blood pressure (hy blud PREH-sher) A blood pressure of 140/90 or higher. High blood pressure usually has no symptoms. It can harm the arteries and cause an increase in the risk of stroke, heart attack, kidney failure, and blindness. Also called hypertension.insulin (IN-suh-lin) A hormone made by the islet cells of the pancreas. Insulin controls the amount of sugar in the blood by moving it into the cells, where it can be used by the body for energy.lung (lung) One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.lung cancer (lung KAN-ser) Cancer that forms in tissues of the lung, usually in the cells lining air passages. The two main types are small cell lung cancer and non-small cell lung cancer. These types are diagnosed based on how the cells look under a microscope.medicine (MEH-dih-sin) Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.mineral (MIH-neh-rul) In medicine, a mineral is a nutrient that is needed in small amounts to keep the body healthy. Mineral nutrients include the elements calcium, magnesium, and iron.nicotine (NIH-kuh-TEEN) An addictive, poisonous chemical found in tobacco. It can also be made in the laboratory. When it enters the body, nicotine causes an increased heart rate and use of oxygen by the heart, and a sense of well-being and relaxation. It is also used as an insecticide.nicotine gum (NIH-kuh-TEEN…) A chewing gum that contains a small dose of nicotine, which enters the blood by being absorbed through the lining of the mouth. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine gum.nicotine inhaler (NIH-kuh-TEEN in-HAY-ler) A device used to inhale (breathe in) small doses of nicotine through the mouth. The nicotine is absorbed through the lining of the mouth and goes into the blood. This helps stop nicotine cravings, and relieves symptoms that occur when a person is trying to quit smoking. A prescription is needed for nicotine inhalers.nicotine lozenge (NIH-kuh-TEEN LAH-zinj) A hard candy-like tablet that contains a small dose of nicotine. The nicotine is absorbed through the lining of the mouth and goes into the blood. This helps stop nicotine cravings, and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine lozenges.nicotine nasal spray (NIH-kuh-TEEN NAY-zul…) A nose spray that contains a small dose of nicotine, which enters the blood by being absorbed through the lining of the nose. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is needed for nicotine nasal spray.nicotine patch (NIH-kuh-TEEN...) A patch that sticks on the skin and contains a small dose of nicotine, which enters the blood by being absorbed through the skin. This helps stop nicotine cravings and relieves symptoms that occur when a person is trying to quit smoking. A prescription is not needed for nicotine patches.overweight (OH-ver-WAYT) Being too heavy for one’s height. Excess body weight can come from fat, muscle, bone, and/or water retention. Being overweight does not always mean being obese.PDQ PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.placebo (pluh-SEE-boh) An inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.pregnancy (PREG-nun-see) The condition between conception (fertilization of an egg by a sperm) and birth, during which the fertilized egg develops in the uterus. In humans, pregnancy lasts about 288 days.prevention (pree-VEN-shun) In medicine, action taken to decrease the chance of getting a disease or condition. For example, cancer prevention includes avoiding risk factors (such as smoking, obesity, lack of exercise, and radiation exposure) and increasing protective factors (such as getting regular physical activity, staying at a healthy weight, and having a healthy diet).protective factor (proh-TEK-tiv FAK-ter) Something that may decrease the chance of getting a certain disease. Some examples of protective factors for cancer are getting regular physical activity, staying at a healthy weight, and having a healthy diet.quality of life (KWAH-lih-tee ... life) The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.recurrence (ree-KER-ents) Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrent cancer.risk factor (... FAK-ter) Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.side effect (side eh-FEKT) A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.suicide (SOO-ih-SIDE) The act of taking one's own life on purpose.supplementation (SUH-pleh-men-TAY-shun) Adding nutrients to the diet.survivor (ser-VY-ver) One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.symptom (SIMP-tum) An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.ulceration (UL-seh-RAY-shun) The formation of a break on the skin or on the surface of an organ. An ulcer forms when the surface cells die and are cast off. Ulcers may be associated with cancer and other diseases.vitamin (VY-tuh-min) A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E. |
