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Smoking Cessation Near Time of Lung Cancer Diagnosis May Improve Survival

Key Points

  • The median survival for patients with lung cancer who reported they had stopped smoking was 28 months, compared with 18 months for those who continued to use tobacco.
  • The survival advantage for those who stopped smoking was adjusted for demographics, disease stage, and other health characteristics.
  • Mortality rates for those who relapsed were similar to current users.

Tobacco cessation provided a significant survival benefit for patients with lung cancer who quit smoking shortly before or after diagnosis, despite the severity of the disease. Results of this Roswell Park Cancer Institute–led study were published by Dobson Amato et al in the Journal of Thoracic Oncology.

Roswell Park has a unique Tobacco Assessment and Cessation Service (TACS) that conducts a standardized tobacco use assessment for patients with lung cancer treated in the Thoracic Center and automatically refers patients who smoke to a dedicated tobacco cessation counseling service.

Study Findings

Using data from TACS, 250 patients participated in the study. Those who had recently stopped smoking (50 patients) or quit after their first contact with TACS (71 patients) had reduced mortality rates compared with patients who continued to use tobacco. The median survival for patients who reported they had stopped smoking was 28 months, compared with 18 months for those who continued to use tobacco. The survival advantage for those who stopped smoking was adjusted for demographics, disease stage, and other health characteristics.

“To our knowledge, this is one of the first studies to examine the impact of tobacco cessation on survival among lung cancer patients who participated in a mandatory assessment and automatic referral to a tobacco cessation service,” said senior author Mary Reid, MSPH, PhD, Director of Cancer Screening and Survivorship at Roswell Park.

Results also suggested that there might be a survival benefit even if a patient has not completely quit tobacco use but continues to attempt to quit after a cancer diagnosis. Mortality rates for those who relapsed were similar to those for current users.

Cessation Services Essential

Tobacco use among patients with lung cancer is rarely collected in a standardized, prospective manner that can be used for clinical outcomes research, according to Dr. Reid. However, TACS collects standardized tobacco use information at diagnosis and follow-up. The researchers recommend that given the impact of smoking cessation on improved cancer survival, structured smoking assessments administered at regular intervals should be included as standard of care in clinical practice and clinical trials.

“Establishing services to accurately screen for tobacco use and easily accessible cessation programs are essential in the cancer care setting to further improve the survival time and quality of life of patients,” Dr. Reid added.

This study was supported by the Roswell Park Alliance Foundation, the National Cancer Institute, and the American Cancer Society.

Michael K. Cummings, PhD, received a grant from Pfizer for testing an inpatient hospital tobacco cessation service. In addition, Dr. Cummings and Martin C. Mahoney, MD, PhD, both served as expert witnesses for the plaintiffs in tobacco litigation cases. The other authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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