Assessing Tobacco Use by Cancer Patients and Facilitating Cessation: An American Association for Cancer Research Policy Statement

Abstract

Executive Summary When diagnosed with cancer, patients can immediately make a meaningful positive impact on their health by stopping their tobacco use. Scientific evidence clearly shows that tobacco use in patients with cancer leads to poorer outcomes. The specific biological processes driving tobacco consumption’s interference in cancer therapy are the subject of continuing research, but the evidence is clear that tobacco use in patients with cancer leads to decreased treatment efficacy and safety, decreased survival, decreased quality of life, increased treatment-related toxicity, and increased risk of cancer recurrence and second primary tumors. Data suggest that tobacco cessation can improve outcomes and survival in patients with cancer, yet full execution of evidence-based cessation interventions is infrequent in oncology settings. Therefore, both improved provision of cessation assistance to all patients with cancer who use tobacco or have recently quit and further study of the deleterious effects of tobacco use and benefits of tobacco cessation on cancer progression and treatment are needed and recommended by the American Association for Cancer Research. Progress on both fronts begins with universal assessment and documentation of tobacco use as a standard of quality cancer care regardless of treatment setting and will be further facilitated through the development of reliable, valid, and standard measures of tobacco use, incorporation of evidence-based procedures into quality and accreditation procedures, and the development of appropriate training, clinical infrastructure, and incentives for delivery of tobacco cessation interventions.

Electronic Nicotine Delivery Systems: A Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology

“…The risks of lung cancer have increased in both men and women over the past 50 years as a result of changes in the design and composition of cigarettes (2). Moreover, continued smoking by cancer patients and survivors reduces the effectiveness of cancer treatments and causes increased overall mortality, cancer-specific mortality, and risk for second primary cancer (2,3). Preventing tobacco use initiation and facilitating cessation are the best ways to combat the problems caused by smoking.…”

Oncology Healthcare Providers‘ Pivotal role in Smoking Cessation and Relapse Prevention

“…Consistent with the Clinical Practice Guidelines, the American Association for Cancer Research (AACR) recently issued a policy statement specific to the oncology setting recommending that evidence-based tobacco cessation assistance should be provided to all patients with cancer who use tobacco or have recently quit [14]. Previous research, however, suggests that in both general and oncology settings, adherence to these recommendations is poor.…”

“…As noted in the AACR, National Cancer Institute and American Society of Clinical Oncology policy recommendations [14,17,18], assessment and documentation of tobacco use is necessitated in all clinical cancer settings. Benefits of tobacco assessment extend beyond the clinical utility of serving as prompts for provider engagement and linking to consults for tobacco treatment specialists, to furthering research on the role of tobacco on cancer treatment and survival [14].…”

“…Benefits of tobacco assessment extend beyond the clinical utility of serving as prompts for provider engagement and linking to consults for tobacco treatment specialists, to furthering research on the role of tobacco on cancer treatment and survival [14]. Moreover, lack of tobacco assessment in the majority of clinical trials inhibits analyses regarding the potential confounding effects of tobacco on clinical trial results [14].…”

Controlled Settings for Lung Cancer Screening: Why Do They Matter? Considerations for Referring Clinicians

“…For patients diagnosed with lung cancer through screening, smoking cessation interventions improve therapeutic benefit and prognosis. The effect of smoking cessation can equal, or even exceed, the positive therapeutic effects of chemotherapeutic agents 22 .…”