Quitting smoking after cancer diagnosis improves survival across wide variety of cancers: JAMA

Smokers who are diagnosed with cancer now have more incentive to quit, as researchers from The University of Texas MD Anderson Cancer Center have found survival outcomes were optimized when patients quit smoking within six months of their diagnosis.

Study results, published today in JAMA Oncology, found a 22%-26% reduction in cancer-related mortality among those who had quit smoking within three months after tobacco treatment began. The best outcomes were observed in patients who started tobacco treatment within six months of a cancer diagnosis and were abstinent from smoking three months later. Survival for these patients increased from 2.1 years for smokers to 3.9 years for abstainers.

"While smoking cessation is widely promoted across cancer centers for cancer prevention, it remains under-addressed by many oncologists in their routine care," said principal investigator Paul Cinciripini, Ph.D., chair of Behavioral Science and Executive Director of the Tobacco Research and Treatment Program at MD Anderson. "Our research underscores the critical role of early smoking cessation as a key clinical intervention for patients undergoing cancer treatment."

Tobacco use remains the leading preventable cause of death and disease in the U.S. According to the Surgeon General, smoking at or following a cancer diagnosis increases both all-cause and cancer-specific mortality, as well as risk for disease progression and tobacco-related second primary cancers. Each year, about 480,000 Americans die from tobacco-related illnesses.

The average smoker makes several attempts to quit before successfully beating the addiction. MD Anderson’s Tobacco Research and Treatment Program tackles the barriers to cessation at an individual and population level, and conducts research designed to change clinical practice by addressing knowledge gaps among health care providers on treating tobacco addiction.

In the current study, researchers followed a cohort of 4,526 current smokers who had been diagnosed with cancer and were receiving cessation treatment at MD Anderson. The patients included men and women aged 47 to 62. More than 95% of visits in the study were provided via telemedicine. Abstinence was defined as self-reported no smoking in the seven days before each assessment, at the three-, six- and nine-month follow-up marks. The primary outcome was survival recorded by the MD Anderson tumor registry.

"This is a call to action for experts, regulatory bodies and institutions to prioritize smoking cessation as an integral part of first-line cancer care," Cinciripini said. "MD Anderson has made a significant investment in clinical care and research related to tobacco use, which at the individual patient level translates to a better quality of life and a longer one, for those who quit smoking. The earlier the engagement in tobacco cessation treatment the greater impact on a patient’s lifespan.”

Reference:

Cinciripini PM, Kypriotakis G, Blalock JA, et al. Survival Outcomes of an Early Intervention Smoking Cessation Treatment After a Cancer Diagnosis. JAMA Oncol. Published online October 31, 2024. doi:10.1001/jamaoncol.2024.4890