Smoking Cessation

Reviewed by: HU Medical Review Board | Last reviewed: January 2017.

Smoking is the major cause of both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), with an estimated 90% of all lung cancers due to active smoking. Smoking has also been attributed to 80% of lung cancer deaths in women and 90% of lung cancer deaths in men.1

Quitting smoking is important to reduce the risk of developing lung cancer, and for those people who already have lung cancer, stopping smoking is also vitally important.

How Does Continuing Smoking Impact Lung Cancer Patients?

Smoking contributes to the development of cancer by causing mutations in the genes, the blueprints of the cells of the body. These mutations can continue even after cancer is diagnosed, creating potential new cancers or potentially more aggressive tumors. Smoking also decreases the body’s immune response, the body’s natural defense against cancer cells and foreign substances that can cause infection or disease.2

Data from several studies suggests that continued smoking may reduce the effectiveness of treatment and increase the chances of a second cancer. Continuing to smoke during lung cancer treatment may also worsen the side effects experienced with treatment. Because smoking suppresses the immune system and slows wound healing, it can also slow recovery from surgery. Several studies have shown the effects of smoking during cancer treatment contribute to a lower survival rate.2

Challenges of Smoking Cessation

Smoking is a powerful physical and behavioral addiction that can be challenging for anyone to stop. While most patients with a smoking-related cancer, like lung cancer, make serious attempts to quit when they learn of their diagnosis, many people need several attempts before they can remain abstinent from smoking. One of the most common triggers for relapse is a stressful situation, and dealing with a life-threatening disease like lung cancer is stressful for patients. In addition, studies have suggested that patients who have anxiety or depression, mood disorders that are common among lung cancer patients, may have more difficulty quitting smoking. However, some patients are able to quit smoking and stay abstinent, and there are medications, techniques and tools to help.2,3

Getting Help with Smoking Cessation

There are many programs, strategies, and medications that can help people stop smoking. Some people find that counseling is helpful. Other complementary approaches include hypnosis, a type of therapy in which the patient gives consent to enter into an altered state of consciousness and the therapist makes suggestions to create healthy behavior changes, such as quitting smoking.2,4

Several pharmaceutical products have been developed that have shown benefit in helping people quit smoking. There are several nicotine replacement products, which come in a variety of formats including gum, lozenge, patch, nasal spray, or inhaler. Nicotine replacement therapies can aid in dealing with the withdrawal symptoms associated with nicotine. Some are available over-the-counter (without a prescription) while others are available only with a prescription.2

Other prescription medications have also been shown to be valuable in helping people quit smoking, including an agent that targets nicotine receptors, Chantix® (varenicline), and an agent that targets neurotransmitters (the chemical messengers in the brain), Zyban® (bupropion HCl). These medications have potential risks as well, and while data suggests they can help with smoking cessation in the general population, they have not been studied specifically in cancer patients.2

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