Answers to This and Other Questions About
Quitting Smoking After a Cancer Diagnosis
by Anthony J. Alberg, PhD, MPH
Why quit smoking after you’ve been diagnosed with cancer? The damage from smoking has already been done, right? So isn’t it too late to worry about quitting now? Besides, you’ve got more pressing matters to deal with, like cancer treatment. Quitting smoking should be low on your priority list, don’t you think?
WRONG. These old ways of thinking have now been transformed by evidence that demonstrates the substantial benefits of smoking cessation among cancer survivors. In fact, if you’re a cancer survivor who smoke cigarettes, quitting smoking not only will improve your quality of life, but it can help you live longer.
Why does quitting smoking matter? What are the benefits of smoking cessation in cancer survivors?
Let’s think about this answer in terms of short-term benefits and long-term benefits. We’ll start with the immediate benefits.
Cigarette smoking is a major source of inflammation, immune system dysregulation, and oxidative stress – all factors that lead to diminished health status in the near term. And these effects last for as long as a person continues smoking. Quitting, however, stops these damaging processes and significantly reduces inflammation straightaway, which gives you a more fully functioning immune system to better fight off infections. Moreover, people who quit smoking consistently report a better self-rated health status than do those who continue to smoke.
The value of quitting smoking is further amplified by its long-term benefits. Cigarette smoking not only increases your risk of cancer recurrence, but it also heightens your chances of being diagnosed with a new primary cancer. It is likewise a major contributing factor in several other life-threatening diseases, including heart disease, stroke, and chronic obstructive pulmonary disease, or COPD. Additionally, according to the 2014 Surgeon General’s Report, cigarette smoking in cancer survivors is linked to poorer response to cancer treatment, increased treatment-related toxicity, adverse health outcomes, and poorer prognosis. As a result, cancer survivors who continue to smoke experience significantly shorter survival than those who quit smoking.
On the other hand, the 2020 Surgeon General’s Report summarizes evidence that shows a strong link between smoking cessation in cancer survivors and reduced all-cause mortality, which means smoking cessation is associated with significantly improved survival. This alone makes quitting smoking a critical step for helping you live longer as a cancer survivor.
When is the best time to quit smoking?
Not only is smoking a major cause of disease and death, but the harmful toxins in cigarette smoke can interfere with cancer treatments. Cigarette smoking impairs wound healing and significantly increases surgical complications. It can also negatively interact with cancer chemotherapies and radiation treatments.
For these reasons, the ideal time to quit smoking is right after diagnosis, before your cancer treatments begin. Think of it as the first step in the cancer treatment process.
What if I have already completed my cancer treatment and I still smoke? Is it ever too late to quit smoking?
No, it is never too late to quit smoking. When you quit smoking, your risks of the harmful health outcomes caused by cigarette smoking will decrease right away.
But don’t you agree that quitting smoking is very difficult?
Given these powerful reasons to stop smoking, the question for cancer survivors becomes not whether to try to quit but how to try to quit. Although, let’s be frank: nicotine addiction makes it extremely difficult to quit.
Most people who smoke cigarettes started smoking when they were teenagers and then quickly became addicted. However, once they become adults, most smokers desperately want to quit. Even so, the powerful addictiveness of nicotine can be difficult to overcome.
For some smokers, quitting for good may seem impossible, especially for those who’ve made multiple quit attempts and returned to smoking each time. Just know that quitting smoking is a challenging goal to achieve. Having difficulty quitting is common and is not a personal failing.
If smoking is so addictive, how can I ever quit for good?
Give yourself the best chance to quit. Combining your personal effort with the right help gives you the highest probability of success. The recommended evidence-based approach to smoking cessation is a combination of counseling and proven stop-smoking medications.
Counseling involves working with a professional trained to address the issues that arise during the quitting process. Having a counselor to help guide you on the journey to smoking cessation significantly increases your chance of success.
As for smoking cessation medications, many have been carefully tested in randomized controlled trials and shown to be safe and effective. These include various forms of nicotine replacement therapy, Chantix, and bupropion.
Surprisingly, some smokers avoid nicotine replacement therapy because they feel it “just replaces one poison with another.” This is simply not true. Nicotine replacement therapy delivers much lower nicotine doses than cigarettes do – and without all the toxins present in cigarette smoke. Nicotine replacement can safely be delivered in several ways, including skin patches, gum, lozenges, and inhalers.
So, to summarize, if you want to give yourself the best chance for success with quitting smoking, you should combine counseling with stop-smoking medications. However, if you are unable to implement both strategies, remember that even just doing counseling alone or stop-smoking medications alone significantly increases the likelihood of a successful quit attempt compared with trying to quit “cold turkey.”
What about using e-cigarettes to help me quit smoking?
While randomized trials have shown promising results, the evidence is not yet sufficient for e-cigarettes to be approved by the U.S. Food and Drug Administration as a smoking cessation tool. Furthermore, the harms of
e-cigarettes are not yet well understood.
Cancer-causing toxins, such as arsenic and chromium, have been found in the vapor from some e-cigarettes, raising concerns about the adverse health effects of these products. Until we can get a better understanding of the risks and benefits of e-cigarettes, the prudent course of action is to use proven safe and effective stop-smoking medications such as those described above to help you quit smoking.
A Final Word
If you are a cancer survivor who smokes, quitting smoking is one of the most important steps you can take to prolong your life. The evidence is clear on this.
It is never too late to reap the health benefits from quitting smoking. No matter how you try to stop smoking, the important thing is that you try.
Dr. Anthony Alberg is a professor with and chair of the Department of Epidemiology and Biostatistics at the University of South Carolina’s Arnold School of Public Health in Columbia, SC.
This article was published in Coping® with Cancer magazine, November/December 2022.