Virtual Library

Start Your Search

Magdalena Cedzynska



Author of

  • +

    ES21 - The "How To" of Modern Tobacco Control (ID 152)

    • Event: WCLC 2020
    • Type: Educational Session
    • Track: Risk Reduction and Tobacco Control
    • Presentations: 1
    • +

      ES21.03 - The Specifics of Smoking Cessation for Cancer Patients (ID 3965)

      09:15 - 10:15  |  Presenting Author(s): Magdalena Cedzynska

      • Abstract
      • Presentation
      • Slides

      Abstract

      Tobacco use remains the main single cause of premature deaths worldwide, and the most attributable risk factor for cancer, causing one third of all cancer deaths. Lung cancer is occurring almost exclusively among tobacco smokers. Evidence suggests that current smoking increases risk of death and negatively impacts survival for patients with cancer in variety of diseases sites. Smoking cessation brings many benefits such as improved survival, treatment outcomes, health-related quality of life, decreased treatment-related toxicity, drug side effects and surgical complications. Moreover, health benefits could be gained even after a cancer diagnosis, regardless of stage and prognosis. Despite the well-established evidence, only few oncologists provide smoking cessation support for their patients. Additionally, many cancer centers report that they fall short of providing consistent, high-quality smoking cessation service. Only few cancer care institutions utilize systematic and consistent mechanism to foster cessation among patients with cancer. Although, oncologists play a critical role in motivating their patients, when they speak directly to them about the importance of smoking cessation, they are often overloaded with other tasks. Additionally, they self-report many concerns and beliefs regarding their smoking patients, which are significant barriers. The principal barriers to physicians promoting smoking cessation are: pessimism regarding their ability to help patients stop using tobacco, and concerns about patient resistance to receiving advice about smoking cessation treatment. Only a third of thoracic oncologists felt that they were adequately trained to provide cessation interventions (counselling and pharmacotherapy). From the other side there are also barriers on the patients side. i.e. they are usually highly addicted, demonstrating high level of depressive symptoms, stress, feeling of guiltiness, anxiety. They do not know the benefits of quitting for the anticancer treatment outcomes. Quitting smoking is a difficult process for many tobacco users; it can add additional stress to an already stressful cancer treatment regimen.

      According to evidence from studies there are some factors that promote long-term abstinence in cancer patients population. They are, similar as in general population, higher education level, lower dependence, and some specific for the cancer population: shorter time from diagnosis, lower alcohol consumption, lower level of anxiety and depression and combined anticancer treatment than single modality treatment.

      Data from different successful programs implemented in cancer centres suggests that there are some organizational issues that should be taken into account when organize help for smokers. There are among others: introduction of an opt-out referral process since it appears to increase referral acceptance, engaging all team members (nurses, doctors, dieticians etc), education to both oncology providers and patients about the importance of quitting smoking during cancer treatments. Smoking cessation intervention should be always tailored to the patients readiness. It is probably a malpractice to insist on quitting smoking as soon as possible for someone who is not ready to quit. Research shows a high proportion of people entering the program and a low percentage of abstinence, perhaps because of the emphasis on quitting without taking into account readiness to stop. Some data shows as well that stepped model might be useful.

      Although tobacco cessation remains a challenging issue in the oncology population, it seems unreasonable to expect oncologists to provide comprehensive smoking cessation treatment to their patients. The most successful cessation programs are referral-based, dedicated comprehensive treatment programs, to which oncologists can easily refer their patients who smoke.

      References:

      Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Transl Lung Cancer Res. 2019 May;8(Suppl 1):S50-S58. doi: 10.21037/tlcr.2019.04.01. PMID: 31211105; PMCID: PMC6546630.

      Shields PG, Herbst RS, Arenberg D, Benowitz NL, Bierut L, Luckart JB, Cinciripini P, Collins B, David S, Davis J, Hitsman B, Hyland A, Lang M, Leischow S, Park ER, Purcell WT, Selzle J, Silber A, Spencer S, Tanvetyanon T, Tiep B, Tindle HA, Tucker-Seeley R, Urbanic J, Hooper MW, Weksler B, Whitlock CW, Wood DE, Burns J, Scavone J. Smoking Cessation, Version 1.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016 Nov;14(11):1430-1468. doi: 10.6004/jnccn.2016.0152. PMID: 27799513.

      Gritz E. R. (2000). Facilitating smoking cessation in cancer patients. Tobacco control, 9 Suppl 1(Suppl 1), I50. https://doi.org/10.1136/tc.9.suppl_1.i50

      Warren GW, Marshall JR, Cummings KM, Toll BA, Gritz ER, Hutson A, Dibaj S, Herbst R, Mulshine JL, Hanna N, Dresler CA. Addressing tobacco use in patients with cancer: a survey of American Society of Clinical Oncology members. J Oncol Pract. 2013 Sep;9(5):258-62. doi: 10.1200/JOP.2013.001025. Epub 2013 Jul 29. PMID: 23943904; PMCID: PMC3770508.

      Nayan S, Gupta MK, Strychowsky JE, Sommer DD. Smoking cessation interventions and cessation rates in the oncology population: an updated systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2013 Aug;149(2):200-11. doi: 10.1177/0194599813490886. Epub 2013 May 28. PMID: 23715685.

      Nayan S, Gupta MK, Sommer DD. Evaluating smoking cessation interventions and cessation rates in cancer patients: a systematic review and meta-analysis. ISRN Oncol. 2011;2011:849023. doi: 10.5402/2011/849023. Epub 2011 Jul 10. PMID: 22091433; PMCID: PMC3195844.

      Cox LS, Africano NL, Tercyak KP, Taylor KL. Nicotine dependence treatment for patients with cancer. Cancer. 2003 Aug 1;98(3):632-44. doi: 10.1002/cncr.11538. Erratum in: Cancer. 2003 Sep 1;98(5):1104. PMID: 12879483.

      Little MA, Klesges RC, Bursac Z, Ebbert JO, Halbert JP, Dunkle AN, Colvin L, Goedecke PJ, Weksler B. Why Don't Cancer Survivors Quit Smoking? An Evaluation of Readiness for Smoking Cessation in Cancer Survivors. J Cancer Prev. 2018 Mar;23(1):44-50. doi: 10.15430/JCP.2018.23.1.44. Epub 2018 Mar 30. PMID: 29629348; PMCID: PMC5886494.

      Warren GW, Marshall JR, Cummings KM, Toll B, Gritz ER, Hutson A, Dibaj S, Herbst R, Dresler C; IASLC Tobacco Control and Smoking Cessation Committee. Practice patterns and perceptions of thoracic oncology providers on tobacco use and cessation in cancer patients. J Thorac Oncol. 2013 May;8(5):543-8. doi: 10.1097/JTO.0b013e318288dc96. PMID: 23529191; PMCID: PMC3628367.

      Vander Ark W, DiNardo LJ, Oliver DS. Factors affecting smoking cessation in patients with head and neck cancer. Laryngoscope. 1997 Jul;107(7):888-92. doi: 10.

      Only Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login, select "Add to Cart" and proceed to checkout. If you would like to become a member of IASLC, please click here.

      Only Active Members that have purchased this event or have registered via an access code will be able to view this content. To view this presentation, please login or select "Add to Cart" and proceed to checkout.