Reducing Tobacco Use Before and After a Cancer Diagnosis

At least 20 different types of cancer have been linked to tobacco use, and more than 160,000 cancer deaths each year in the United States are attributable to smoking. Major reductions in tobacco use among American adults—from a high of 42% of the adult population in 1965 to about 15% today—have lowered the number of deaths from lung cancer and other tobacco-related diseases; however, lung cancer still claims more lives among U.S. men and women than any other cancer type.

Cancer patients who continue to smoke after diagnosis may face additional tobacco-related harms. For example, NCI-funded research has shown that continued smoking increases the risk of second cancers in patients with head and neck cancer, increases risks of recurrence and reduced survival in patients with prostate cancer, and increases risks of death from breast and respiratory tract cancers in women diagnosed with breast cancer. Other NCI-funded research has shown that cancer patients who continue to smoke experience a greater burden of treatment-related side effects than nonsmokers, which may lead to treatment interruptions, reductions in treatment doses, and delays in treatment that can, in turn, compromise treatment effectiveness and reduce survival. However, more research is needed to fully understand the impact of continued smoking on cancer patients, particularly on the effectiveness of cancer therapy.

Additional research and resources are also needed to further reduce the harms of tobacco use among individuals who have not been diagnosed with cancer, especially those in at-risk populations for tobacco uptake, including the young and the socioeconomically disadvantaged.

Research Priorities

Support Research on Tobacco Prevention and Cessation

To help guide NCI’s tobacco control research agenda through the year 2025, the institute established the Tobacco Control Research Priorities Working Group in 2015. This group, led by Michael Fiore, M.D., M.P.H., M.B.A., of the University of Wisconsin School of Medicine and Public Health, presented its report to NCI’s Board of Scientific Advisors in 2016. (Read about Michael’s perspective.) The working group’s recommendations included a call for focused efforts to improve the effectiveness and accessibility of tobacco prevention and cessation interventions and to discourage tobacco use by vulnerable populations. NCI is well positioned to support the working group’s recommendations.

Implement Effective Tobacco Prevention and Cessation Interventions

The development and implementation of effective tobacco cessation interventions for cancer patients and those at increased risk of cancer is a high priority for NCI. For example, the institute:

  • Supports tobacco cessation at NCI-Designated Cancer Centers: Evidence-based tobacco cessation interventions designed for individuals without cancer should be offered as part of the coordinated care of all cancer patients. However, comprehensive tobacco cessation programs are not currently available at all NCI-Designated Cancer Centers that provide patient care services. Therefore, NCI is making supplemental funding available to help cancer centers plan, implement, evaluate, and sustain tobacco cessation programs for cancer patients who smoke. In addition, NCI has awarded grants to six cancer centers to conduct research on the design and implementation of tobacco cessation interventions for patients undergoing lung cancer screening with low-dose CT scans.
  • Hosts the Smokefree.gov website to make information and resources about smoking cessation available to the public, health professionals, and researchers. In 2016, 4.5 million smokers interacted with Smokefree.gov.

Stories of Impact

NCI leads efforts to reduce tobacco use to prevent more cancers and improve the outcomes for patients and survivors.

Working to Reduce the Cancer Burden Caused by Tobacco

Every year, 70% of smokers in the United States visit a health care professional. Many, however, leave without receiving any smoking cessation assistance. Approximately half of smokers diagnosed with cancer continue to smoke, and only some health care centers provide these patients with services to quit. “This is a missed opportunity to help people become healthier and live longer,” said physician and researcher Michael Fiore.

Key Takeaway

  • NCI supports research to develop and implement evidence-based measures to reduce the use of tobacco products among all individuals, including populations that are vulnerable to the initiation of tobacco use and patients who are undergoing or have completed active cancer treatment.