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JAMA Patient Page
October 13, 2020

Smoking Cessation and Cancer Survivorship

Author Affiliations
  • 1Department of Population Health, New York University School of Medicine, New York, New York
  • 2Department of Urology, New York University School of Medicine, New York, New York
  • 3Department of Urology, University of North Carolina School of Medicine, Chapel Hill
JAMA. 2020;324(14):1475. doi:10.1001/jama.2020.16277

Quitting smoking can lower the chance of dying from cancer, and can help cancer treatments work better and lower the risk of treatment complications.

A cancer diagnosis is a stressful life event. Coping with the difficulty and uncertainty of cancer treatment while also trying to quit smoking is even more challenging. Smoking cessation (quitting) can improve overall health and quality of life and can also lower the chance of dying from cancer. Quitting smoking can also help cancer treatments work better and lower the risk complications from treatment. Talking about smoking with your doctor is the most important first step toward quitting and will help your doctor provide you with the necessary support and tools to quit.

Your doctor should review the benefits of smoking cessation and discuss how it relates to your personal medical issues and cancer treatment plan, as well as evaluate your readiness to quit, quitting-related goals, and why prior attempts to quit may not have been successful.

Ways to Quit Smoking

Quitting smoking is worthwhile for everyone. However, the way each person quits smoking should be personalized to their unique needs. There are different and complementary approach quitting; in general, the most effective way to quit involves a combination of counseling and medications.

Counseling

Counseling (behavioral therapy) has many forms, such as face to face in a one-on-one setting, as part of a group, or via telemedicine (by phone, video visits, and/or text messages). Behavioral therapy helps support attempts to quit by providing coping strategies that help with cravings and manage withdrawal symptoms (which usually peak within 2-3 days of quitting). These sessions can also help identify triggers to avoid and overcome barriers to successfully quitting during prior attempts. Many patients undergoing cancer treatment or in remission find that counseling can help with more than just quitting smoking.

Medications

The 2 broad categories of medications that can help you quit smoking are prescription medicines and over-the-counter drugs such as many nicotine replacement therapies (NRTs). Varenicline and bupropion are 2 approved prescription medications to help patients quit smoking. These drugs are generally safe, with nausea the most common side effect. However, some patients with seizure or psychiatric histories may not be able to take them. Types of NRTs include patches, gum, and lozenges. These therapies reduce the body’s craving for nicotine (the addictive chemical in cigarettes) and help you avoid smoking. Your doctor may want you to use one or both types of medications at the same time; usually, patients are recommended to use these medications for a minimum of 12 weeks.

Publicly Available Resources to Help You Quit

As with all aspects of medical care, a discussion with a primary care doctor or oncologist should help guide decision-making. However, publicly available resources such as 1-800-QUIT-NOW or smokefree.gov are good starting points. The first step is recognizing the importance of quitting smoking to your general health and cancer treatment.

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The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, email reprints@jamanetwork.com.
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Article Information

Financial Disclosures: None reported.

Sources: US Preventive Services Task Force. Primary care interventions for prevention and cessation of tobacco use in children and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2020;323(16):1590-1598. doi:10.1001/jama.2020.4679

Cinciripini PM, Karam-Hage M, Kypriotakis G, et al. Association of a comprehensive smoking cessation program with smoking abstinence among patients with cancer. JAMA Netw Open. 2019;2(9):e1912251. doi:10.1001/jamanetworkopen.2019.12251

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