Around 25% of people with cancer in the U.S. are active smokers when they are diagnosed, and studies have found that many of them continue to smoke during treatment. This may be due in part to a common misconception – even among some doctors – that quitting won’t help much if a person already has cancer, particularly if it’s at an advanced stage.
Now, a study led by Li-Shiun Chen, MD, a professor of psychiatry at Washington University School of Medicine in St. Louis, shows that kicking the habit after starting cancer treatment is well worth it – and what’s more, smokers with the most advanced cancers glean the biggest benefit from quitting, more than doubling their survival time.
Patients in Chen’s study had help quitting through a smoking cessation program developed and administered at Siteman Cancer Center, based at Barnes-Jewish Hospital and WashU Medicine.
The program offers a unique approach to cancer care by integrating smoking cessation interventions into patients’ cancer treatment plans. Delivering all treatment on-site eliminates hurdles involving time and transportation.
Chen’s findings were published Oct. 9 in the Journal of the National Comprehensive Cancer Network.
“WashU Medicine and Siteman are the leading frontier to ensure every cancer patient is offered tobacco treatment as part of their cancer care, using a novel, informatics-enabled, point-of-care model,” said Chen, who also directs the Tobacco Treatment Program at Siteman. “By showing that it’s never too late, even for the sickest patients, we hope to inspire all cancer centers and patients to include smoking cessation support as part of routine cancer care to improve survival.”
In the study, Chen and her collaborators followed 13,282 adults who received outpatient oncology care during a six-month period at Siteman. The team recorded each participant’s smoking status at their initial visit, then tracked cessation rates over the next six months along with survival over the next two years. Of 1,725 patients who reported at their first visit that they smoked, about one-fifth of them quit within the following six months.
Across all cancer types and stages, the researchers found that the probability of survival two years after patients’ initial oncology visit was 74% among those who continued smoking, versus 85% among those who quit. This benefit was driven mainly by patients with late-stage cancers (stage 3 or 4), among whom quitting was associated with a bigger increase in survival rate over this time period compared to people with early-stage cancer (stage 1 or 2).
Examining the results another way, the researchers found that for patients with stage 3 or 4 cancer who kept smoking, 85% were alive at 210 days. In comparison, of those who quit, 85% were still alive at 540 days. That’s nearly a year of additional days of life.